Provider First Line Business Practice Location Address:
2960 SACRAMENTO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94702-2510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-549-3166
Provider Business Practice Location Address Fax Number:
510-255-2314
Provider Enumeration Date:
03/30/2007