Provider First Line Business Practice Location Address:
4501 X ST
Provider Second Line Business Practice Location Address:
UC DAVIS CANCER CENTER, SUITE 3010
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-2172
Provider Business Practice Location Address Fax Number:
916-731-5706
Provider Enumeration Date:
11/29/2005