Provider First Line Business Practice Location Address:
2070 CLINTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-522-4146
Provider Business Practice Location Address Fax Number:
510-522-4954
Provider Enumeration Date:
07/12/2006