Provider First Line Business Practice Location Address:
1050 WISCONSIN
Provider Second Line Business Practice Location Address:
POTRERO HILL HLTH CTR
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94106-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-648-7609
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2007