Provider First Line Business Practice Location Address:
301 E 13TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95341-5355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-261-4739
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2026