Provider First Line Business Practice Location Address:
505 PARNASSUS AVENUE, MOFFITT ROOM M 396, BOX 0628
Provider Second Line Business Practice Location Address:
UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94132-2217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-353-1905
Provider Business Practice Location Address Fax Number:
415-353-1796
Provider Enumeration Date:
04/09/2009