Provider First Line Business Practice Location Address:
1001 POTRERO AVENUE
Provider Second Line Business Practice Location Address:
WARD 17 DIALYSIS CLINIC, BLDG. 100, 3RD FL.
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94110-3510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
628-206-8242
Provider Business Practice Location Address Fax Number:
415-285-2389
Provider Enumeration Date:
08/06/2006