Provider First Line Business Practice Location Address:
3232 ELM ST
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:
94609-3050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-869-8761
Provider Business Practice Location Address Fax Number:
510-869-6903
Provider Enumeration Date:
06/20/2007