Provider First Line Business Mailing Address:
SUITE 900, 2100 POWELL STREET
Provider Second Line Business Mailing Address:
MEDAMERICA ATTN: ANNIE CHANG
Provider Business Mailing Address City Name:
EMERYVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94608-1803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-350-2638
Provider Business Mailing Address Fax Number:
510-879-9128