Provider First Line Business Practice Location Address:
1942 UNIVERSITY AVE STE 208
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:
94704-1073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-666-9900
Provider Business Practice Location Address Fax Number:
510-666-9099
Provider Enumeration Date:
03/19/2014