Provider First Line Business Practice Location Address:
6097 CLAREMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94618-1222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-667-3477
Provider Business Practice Location Address Fax Number:
510-524-4882
Provider Enumeration Date:
12/28/2006