Provider First Line Business Practice Location Address:
12250 SKYLINE BLVD
Provider Second Line Business Practice Location Address:
SKYLINE HIGH SCHOOL
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94619-2425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-879-3060
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2014