Provider First Line Business Practice Location Address:
1441 FRANKLIN ST STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94612-3219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-420-5787
Provider Business Practice Location Address Fax Number:
510-420-5787
Provider Enumeration Date:
04/06/2007