Provider First Line Business Practice Location Address:
8825 OLD SACRAMENTO RD SPC 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95669-9760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-541-5004
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2024