Provider First Line Business Practice Location Address:
KAISER PERMANENTE 5755 COTTLE RD
Provider Second Line Business Practice Location Address:
BUILDING 5
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-972-3264
Provider Business Practice Location Address Fax Number:
408-972-3592
Provider Enumeration Date:
12/18/2006