Provider First Line Business Practice Location Address:
286 SANTA CLARA AVE.
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-788-6110
Provider Business Practice Location Address Fax Number:
510-201-2514
Provider Enumeration Date:
12/29/2006