Provider First Line Business Practice Location Address:
424 E YOSEMITE AVE
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:
95340-8499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-722-5100
Provider Business Practice Location Address Fax Number:
209-722-5200
Provider Enumeration Date:
01/31/2006