Provider First Line Business Practice Location Address:
951 LIVE OAK BLVD
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:
95991-4071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-255-7472
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2025