Provider First Line Business Practice Location Address:
309 MACARTHUR BLVD
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:
94610-3233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-836-3777
Provider Business Practice Location Address Fax Number:
510-836-0516
Provider Enumeration Date:
07/16/2008