Provider First Line Business Practice Location Address:
2059 CLINTON AVE
Provider Second Line Business Practice Location Address:
SUITE#3
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-523-1072
Provider Business Practice Location Address Fax Number:
510-523-1071
Provider Enumeration Date:
02/12/2007