Provider First Line Business Practice Location Address:
2000 POWELL ST
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
EMERYVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94608-1804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-985-9660
Provider Business Practice Location Address Fax Number:
510-985-9664
Provider Enumeration Date:
02/03/2006