Provider First Line Business Practice Location Address:
535 ARCADE BLVD
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:
95815-1118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-692-4242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2026