Provider First Line Business Practice Location Address:
10255 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVE OAK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95953-2015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-695-3700
Provider Business Practice Location Address Fax Number:
530-695-3780
Provider Enumeration Date:
08/15/2014