Provider First Line Business Practice Location Address:
4248 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:
94619-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-530-1335
Provider Business Practice Location Address Fax Number:
510-531-8902
Provider Enumeration Date:
09/20/2006