Provider First Line Business Practice Location Address:
1002 LIVE OAK BLVD # 100A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-4028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-531-8754
Provider Business Practice Location Address Fax Number:
530-420-3633
Provider Enumeration Date:
09/24/2025