Provider First Line Business Practice Location Address:
2238 SANTA CLARA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-521-5141
Provider Business Practice Location Address Fax Number:
510-521-4493
Provider Enumeration Date:
11/20/2006