Provider First Line Business Practice Location Address:
2261 DOUGLAS BLVD
Provider Second Line Business Practice Location Address:
U.C.DAVIS MEDICAL GROUP
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-3831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-783-1044
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2007