Provider First Line Business Practice Location Address:
2430 WEBSTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-843-4550
Provider Business Practice Location Address Fax Number:
510-843-4553
Provider Enumeration Date:
08/06/2007