Provider First Line Business Practice Location Address:
3800 COOLIDGE AVE.
Provider Second Line Business Practice Location Address:
BUILDING H
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-482-2244
Provider Business Practice Location Address Fax Number:
510-485-5351
Provider Enumeration Date:
12/31/2007