Provider First Line Business Practice Location Address: 
155 N FRESNO ST STE 326
    Provider Second Line Business Practice Location Address: 
UCSF(FRESNO) FAMILY MEDICINE RESIDENCY PROGRAM
    Provider Business Practice Location Address City Name: 
FRESNO
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
93701-2302
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
559-499-6450
    Provider Business Practice Location Address Fax Number: 
559-499-6451
    Provider Enumeration Date: 
01/19/2012