Provider First Line Business Practice Location Address:
700 LAWRENCE EXPRESSWAY DEPT 104
Provider Second Line Business Practice Location Address:
KAISER PERMENANTE MEDICAL CENTER
Provider Business Practice Location Address City Name:
SANTA CLARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-236-4930
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2007