Provider First Line Business Practice Location Address:
2001 DWIGHT WAY
Provider Second Line Business Practice Location Address:
DEPT. OF PSYCHIATRY, THIRD FLOOR
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-204-4490
Provider Business Practice Location Address Fax Number:
510-294-3060
Provider Enumeration Date:
10/02/2006