Provider First Line Business Practice Location Address:
2577 CALIFORNIA PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-4166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-365-9197
Provider Business Practice Location Address Fax Number:
530-893-5026
Provider Enumeration Date:
09/16/2026