Provider First Line Business Practice Location Address:
2151 SANTA CLARA AVE
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:
94501-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-865-1244
Provider Business Practice Location Address Fax Number:
510-865-1450
Provider Enumeration Date:
09/30/2005