Provider First Line Business Practice Location Address:
CARDIOVASCULAR DIVISION, J ELLISON AMBULATORY CARE CENT
Provider Second Line Business Practice Location Address:
4860 Y STREET
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:
916-734-8425
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2008