Provider First Line Business Practice Location Address:
3714 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:
94619-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-530-2330
Provider Business Practice Location Address Fax Number:
510-530-4947
Provider Enumeration Date:
06/01/2011