Provider First Line Business Practice Location Address:
450 STANYAN
Provider Second Line Business Practice Location Address:
2ND FLOOR USF STUDENT MEDICAL CLINIC ST MARYS MEDICAL C
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94117-1079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-750-4980
Provider Business Practice Location Address Fax Number:
415-750-8155
Provider Enumeration Date:
01/04/2006