Provider First Line Business Practice Location Address:
3120 WEBSTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94609-3421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-451-5700
Provider Business Practice Location Address Fax Number:
510-451-9830
Provider Enumeration Date:
11/15/2006