Provider First Line Business Practice Location Address: 
513 PARNASSUS AVE # S-321
    Provider Second Line Business Practice Location Address: 
UCSF DEPARTMENT OF SURGERY
    Provider Business Practice Location Address City Name: 
SAN FRANCISCO
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
94143-2205
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
415-476-1239
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/01/2007