Provider First Line Business Practice Location Address:
13620 LINCOLN WAY STE 190
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-3262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-823-1284
Provider Business Practice Location Address Fax Number:
530-823-3491
Provider Enumeration Date:
07/14/2026