Provider First Line Business Practice Location Address:
400 PARNASSUS AVE RM A-581
Provider Second Line Business Practice Location Address:
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94143-0222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-353-4363
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2006