Provider First Line Business Practice Location Address:
1329 CURTIS ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94702-1053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-527-8339
Provider Business Practice Location Address Fax Number:
924-254-8755
Provider Enumeration Date:
05/17/2011