Provider First Line Business Practice Location Address:
9241 OLD STATE HWY UNIT 1170
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWCASTLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95658-1447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-852-3226
Provider Business Practice Location Address Fax Number:
415-741-1707
Provider Enumeration Date:
12/13/2023