Provider First Line Business Practice Location Address:
222 W. 39TH AVENUE
Provider Second Line Business Practice Location Address:
SAN MATEO MEDICAL CENTER - PEDIATRIC CLINIC
Provider Business Practice Location Address City Name:
SAN MATEO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-573-3702
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2013