Provider First Line Business Practice Location Address:
6939 MACARTHUR BLVD
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:
94605-2532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-482-6490
Provider Business Practice Location Address Fax Number:
510-482-6493
Provider Enumeration Date:
12/03/2007