Provider First Line Business Practice Location Address:
1850 SAN PEDRO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-379-4860
Provider Business Practice Location Address Fax Number:
510-601-4002
Provider Enumeration Date:
08/08/2007