Provider First Line Business Practice Location Address:
5299 - COLLEGE AVE.
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-351-5271
Provider Business Practice Location Address Fax Number:
510-351-4378
Provider Enumeration Date:
07/27/2009