Provider First Line Business Practice Location Address:
2320 WOOLSEY ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705-1973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-843-8002
Provider Business Practice Location Address Fax Number:
510-540-4808
Provider Enumeration Date:
07/07/2006