Provider First Line Business Practice Location Address:
7001-A EAST PARKWAY
Provider Second Line Business Practice Location Address:
PUBLIC HLTH SERVICES-ADMIN. STE. # 500
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95823-2034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-875-5701
Provider Business Practice Location Address Fax Number:
916-875-6366
Provider Enumeration Date:
11/16/2006