Provider First Line Business Practice Location Address: 
1200 EL CAMINO REAL
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
SOUTH SAN FRANCISCO
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
94080-3208
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
650-742-2000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
11/20/2006