Provider First Line Business Practice Location Address:
2500 MERCED STREET - SUITE 208
Provider Second Line Business Practice Location Address:
KAISER - PERMANENTE MEDICAL CENTER, DEPARTMENT OF NEPHR
Provider Business Practice Location Address City Name:
SAN LEANDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-454-3167
Provider Business Practice Location Address Fax Number:
510-454-3163
Provider Enumeration Date:
07/05/2006