Provider First Line Business Practice Location Address:
500 UNIVERSITY AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95825-6524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-830-2000
Provider Business Practice Location Address Fax Number:
916-830-2001
Provider Enumeration Date:
05/11/2006