Provider First Line Business Practice Location Address:
2500 MERCED STREET
Provider Second Line Business Practice Location Address:
MOB DEPT 212
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:
510-454-2747
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/09/2010