Provider First Line Business Practice Location Address:
110A MINOR ADDITION
Provider Second Line Business Practice Location Address:
UNIVERSITY OF CALIFORNIA BERKELEY
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94720-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-643-9252
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2014