Provider First Line Business Practice Location Address:
375 WOODSIDE AVE
Provider Second Line Business Practice Location Address:
SPY MEDICAL CLINIC
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94127-1221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-753-7773
Provider Business Practice Location Address Fax Number:
415-753-7822
Provider Enumeration Date:
11/16/2009