Provider First Line Business Practice Location Address: 
2950 INTERNATIONAL BLVD
    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: 
94601-2228
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
510-535-4400
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
01/02/2015