Provider First Line Business Practice Location Address:
4301 X STREET C/O PEDIATRIC ICU
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:
95817-2350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-734-2994
Provider Business Practice Location Address Fax Number:
916-734-0960
Provider Enumeration Date:
05/11/2021