Provider First Line Business Practice Location Address:
221 STOCKTON BLVD.
Provider Second Line Business Practice Location Address:
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:
95817-1418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-820-2362
Provider Business Practice Location Address Fax Number:
214-820-7272
Provider Enumeration Date:
04/14/2008