Provider First Line Business Practice Location Address:
1351 24TH AVE
Provider Second Line Business Practice Location Address:
OCEAN PARK HEALTH CENTER
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94122-1616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-682-1900
Provider Business Practice Location Address Fax Number:
415-753-8134
Provider Enumeration Date:
03/13/2007