Provider First Line Business Practice Location Address:
179 ACACIA AVENUE ROOM 100
Provider Second Line Business Practice Location Address:
DOMINICAN UNIVERSITY STUDENT HEALTH CENTER
Provider Business Practice Location Address City Name:
SAN RAFAEL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-485-3208
Provider Business Practice Location Address Fax Number:
415-458-3755
Provider Enumeration Date:
12/10/2014