Provider First Line Business Practice Location Address:
ONE MEDICAL PLAZA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-3080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-781-1382
Provider Business Practice Location Address Fax Number:
916-781-1383
Provider Enumeration Date:
06/15/2006