Provider First Line Business Practice Location Address:
505 H ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94587-3452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-675-5817
Provider Business Practice Location Address Fax Number:
510-576-7939
Provider Enumeration Date:
04/13/2026