Provider First Line Business Practice Location Address:
3139 SAN PABLO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94608-4533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-595-8474
Provider Business Practice Location Address Fax Number:
510-595-8410
Provider Enumeration Date:
07/28/2006