Provider First Line Business Practice Location Address: 
2030 SUTTER PL
    Provider Second Line Business Practice Location Address: 
SUITE 2000
    Provider Business Practice Location Address City Name: 
DAVIS
    Provider Business Practice Location Address State Name: 
CA
    Provider Business Practice Location Address Postal Code: 
95616-6201
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
530-750-5800
    Provider Business Practice Location Address Fax Number: 
530-750-5804
    Provider Enumeration Date: 
07/24/2007