Provider First Line Business Practice Location Address:
4287 PIEDMONT AVE
Provider Second Line Business Practice Location Address:
STE 112
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94611-4730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-428-9880
Provider Business Practice Location Address Fax Number:
510-428-9884
Provider Enumeration Date:
04/17/2009