Provider First Line Business Practice Location Address:
4141 GEARY BLVD
Provider Second Line Business Practice Location Address:
FLOOR 3 (DEPARTMENT OF PSYCHIATRY)
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94118-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-282-9744
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2011