Provider First Line Business Practice Location Address:
1200 EL CAMINO REAL
Provider Second Line Business Practice Location Address:
SPEECH/LANGUAGE PATHOLOGY & AUDIOLOGY- 1ST FLOOR
Provider Business Practice Location Address City Name:
SOUTH SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94080-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-914-1430
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2010