Provider First Line Business Practice Location Address:
2612 ALCATRAZ AVE STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705-2723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-914-0810
Provider Business Practice Location Address Fax Number:
510-788-6818
Provider Enumeration Date:
11/24/2009