Provider First Line Business Practice Location Address:
1 DANIEL BURNHAM CT
Provider Second Line Business Practice Location Address:
SUITE 365C --RENBAUM MEDICAL GROUP
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94109-5455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-858-5447
Provider Business Practice Location Address Fax Number:
415-922-6344
Provider Enumeration Date:
08/15/2007