Provider First Line Business Practice Location Address:
500 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
SUITE 220 - UCDMG CAMPUS COMMONS
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95825-6504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-286-8700
Provider Business Practice Location Address Fax Number:
916-565-1173
Provider Enumeration Date:
01/16/2007