Provider First Line Business Practice Location Address:
3215 ENCINAL AVE
Provider Second Line Business Practice Location Address:
STE. K
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4889
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-364-3723
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2010