Provider First Line Business Practice Location Address:
210 CENTRAL 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:
94501-3246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-748-4023
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2024