Provider First Line Business Practice Location Address:
4150 V STREET, PSSB SUITE 2100
Provider Second Line Business Practice Location Address:
DEPT OF EMERGENCY MEDICINE, UC DAVIS MEDICAL CENTER
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-8249
Provider Business Practice Location Address Fax Number:
916-734-7950
Provider Enumeration Date:
06/16/2010