Provider First Line Business Practice Location Address:
2241 CENTRAL AVE STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-769-6300
Provider Business Practice Location Address Fax Number:
510-636-1689
Provider Enumeration Date:
04/25/2007