Provider First Line Business Practice Location Address:
3257 FOLSOM BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95816-5220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-330-7420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2026