Provider First Line Business Practice Location Address:
2223 MARTIN LUTHER KING JR WAY
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:
94704-1437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-644-6120
Provider Business Practice Location Address Fax Number:
510-548-4221
Provider Enumeration Date:
08/10/2011