Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Jul 26, 2006
License(s)
G77196 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1201 ALHAMBRA BLVD SUITE 230 | Sacramento, CA 95816-5238 | 916-731-7765 |
| MAILING | 10470 OLD PLACERVILLE RD SUITE 100 | Sacramento, CA 95827-2539 | 855-771-0335 |
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