Provider First Line Business Practice Location Address:
2065 KITTREDGE ST STE E
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:
94704-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-649-9130
Provider Business Practice Location Address Fax Number:
510-649-0627
Provider Enumeration Date:
10/25/2012