Provider First Line Business Practice Location Address: 
1200 EL CAMINO REAL INPATIENT PHARMACY
    Provider Second Line Business Practice Location Address: 
3RD FLOOR TOWER
    Provider Business Practice Location Address City Name: 
SOUTH SAN FRANCISCO
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
94080-3208
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
650-742-2486
    Provider Business Practice Location Address Fax Number: 
650-742-2632
    Provider Enumeration Date: 
09/07/2010