Provider First Line Business Practice Location Address:
2241 CENTRAL AVE.
Provider Second Line Business Practice Location Address:
SUITE B
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:
510-865-4400
Provider Business Practice Location Address Fax Number:
510-865-4417
Provider Enumeration Date:
05/08/2007