Provider First Line Business Practice Location Address:
1425 LEIMERT BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94602-1808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-482-8300
Provider Business Practice Location Address Fax Number:
510-482-7471
Provider Enumeration Date:
04/23/2007