Provider First Line Business Practice Location Address:
5824 MARSHALL ST
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:
94608-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-601-8233
Provider Business Practice Location Address Fax Number:
510-601-8233
Provider Enumeration Date:
04/09/2007