Provider First Line Business Practice Location Address:
1110 CIVIC CENTER BLVD STE 104A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95993-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-467-4405
Provider Business Practice Location Address Fax Number:
916-909-2999
Provider Enumeration Date:
07/17/2026