Active NPI 1912996794 Individual Practitioner Male Practitioner

Dr. Kenneth H Ferguson , MD

Urology • Davis, CA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Ferguson, MD is a certified Urology practicing in Davis, CA. With approximately 27 years of clinical experience since graduating from University Of Virginia School Of Medicine in 1999, Dr. Ferguson delivers high-quality medical care to the local community at 2030 SUTTER PL.

Dr. Ferguson is affiliated with Sutter Valley Medical Foundation and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include injection, onabotulinumtoxina, 1 unit, established patient outpatient office visit, implantation of lower leg neurostimulator electrode, accessed through the skin. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2030 Sutter Pl
Suite 1000

Davis, CA 956166212

Telephone 5307505995

Fax 5307505905

Medicare Profile & Education

Medical School

University Of Virginia School Of Medicine

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Davis, CA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs -2.0 yrs vs City Avg

City Avg: 29.0 Yrs

State Avg: 27.5 Yrs

Regional Practice Density

2 Specialists

Practicing in Davis, CA (1624 Statewide)

Telehealth Adoption Rate

100.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

74.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ferguson (27 Years) 27 Yrs

Davis Specialty Average (29.0 Years) 29.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	6,300	29	$16.00	$6.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	866	553	$357.00	$135.44
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	398	45	$559.00	$128.77
51798 Ultrasound measurement of bladder capacity after voiding	247	212	$89.00	$12.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	206	206	$542.00	$174.92
51741 Electronic assessment of bladder emptying	197	170	$75.00	$9.97
52000 Diagnostic exam of bladder and urethra using an endoscope	184	171	$881.00	$263.20
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	150	17	$792.00	$178.82
99213 Established patient office or other outpatient visit, typically 15 minutes	106	90	$243.00	$96.48
51705 Removal of skin suture with change of bladder tube	106	15	$399.00	$105.05
51701 Insertion of temporary bladder tube	77	55	$229.00	$47.54
51702 Simple insertion of temporary bladder tube	66	18	$307.00	$67.85
51700 Simple bladder irrigation and/or instillation	62	11	$364.00	$81.85
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	49	47	$65.00	$16.94
52287 Exam with injections of chemical for destruction of bladder using an endoscope	38	29	$1377.00	$420.82
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	24	17	$197.00	$39.07
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	20	20	$3440.00	$738.76
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	19	19	$1567.00	$437.51
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	18	17	$1030.00	$345.98
52356 Crushing of stone of ureter with insertion of stent using an endoscope	13	13	$2018.09	$413.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	6,300	22	$15.00	$6.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	886	556	$343.00	$135.29
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	380	37	$532.00	$128.58
51798 Ultrasound measurement of bladder capacity after voiding	206	171	$89.00	$11.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	205	205	$521.00	$176.16
52000 Diagnostic exam of bladder and urethra using an endoscope	184	161	$839.00	$266.23
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	174	19	$792.00	$170.04
51741 Electronic assessment of bladder emptying	156	134	$75.00	$9.86
99213 Established patient office or other outpatient visit, typically 15 minutes	128	107	$234.00	$96.35
51705 Removal of skin suture with change of bladder tube	95	17	$380.00	$105.64
51700 Simple bladder irrigation and/or instillation	71	11	$364.00	$82.91
51701 Insertion of temporary bladder tube	69	48	$229.00	$47.85
J0696 Injection, ceftriaxone sodium, per 250 mg	48	12	$9.00	$0.51
51702 Simple insertion of temporary bladder tube	47	15	$295.00	$67.42
52287 Exam with injections of chemical for destruction of bladder using an endoscope	33	22	$1311.00	$418.95
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	29	19	$188.00	$37.49
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	19	19	$981.00	$348.64
52356 Crushing of stone of ureter with insertion of stent using an endoscope	15	15	$1665.92	$406.29
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	15	15	$3352.11	$749.96
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	12	12	$1106.17	$60.63
55700 Biopsy of prostate gland	12	12	$941.00	$253.51
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	11	11	$461.00	$190.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	6,200	17	$15.00	$6.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	916	566	$333.00	$134.27
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	389	40	$504.00	$131.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	209	209	$506.00	$173.19
51798 Ultrasound measurement of bladder capacity after voiding	189	158	$87.00	$11.42
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	186	19	$775.52	$171.56
52000 Diagnostic exam of bladder and urethra using an endoscope	178	160	$803.00	$266.55
51741 Electronic assessment of bladder emptying	154	130	$74.00	$9.94
99213 Established patient office or other outpatient visit, typically 15 minutes	152	129	$227.00	$95.13
51705 Removal of skin suture with change of bladder tube	84	11	$364.00	$104.53
51701 Insertion of temporary bladder tube	79	62	$222.00	$47.63
51700 Simple bladder irrigation and/or instillation	72	15	$357.00	$83.25
J0696 Injection, ceftriaxone sodium, per 250 mg	38	11	$9.00	$0.49
52287 Exam with injections of chemical for destruction of bladder using an endoscope	32	17	$1255.00	$429.17
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	31	19	$184.00	$36.02
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	25	24	$951.00	$349.31
74420 Imaging of urinary tract	20	19	$95.00	$25.91
52356 Crushing of stone of ureter with insertion of stent using an endoscope	19	18	$1705.60	$444.95
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	17	17	$1153.00	$62.49
55700 Biopsy of prostate gland	16	16	$900.00	$261.83
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	14	14	$3205.00	$750.45
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	14	14	$1428.00	$454.35
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	13	12	$84.00	$15.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	9,100	29	$15.00	$6.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	815	527	$323.00	$136.59
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	435	45	$480.00	$139.61
99213 Established patient office or other outpatient visit, typically 15 minutes	235	188	$220.00	$96.52
51798 Ultrasound measurement of bladder capacity after voiding	202	163	$83.00	$11.23
52000 Diagnostic exam of bladder and urethra using an endoscope	191	174	$803.00	$256.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	189	189	$491.00	$175.19
51741 Electronic assessment of bladder emptying	166	139	$64.00	$9.77
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	110	19	$775.00	$158.11
51705 Removal of skin suture with change of bladder tube	95	12	$364.00	$104.79
51701 Insertion of temporary bladder tube	88	67	$222.00	$48.31
51700 Simple bladder irrigation and/or instillation	67	12	$332.00	$85.67
52287 Exam with injections of chemical for destruction of bladder using an endoscope	48	29	$1170.00	$422.13
74420 Imaging of urinary tract	34	29	$87.00	$26.23
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	30	19	$184.00	$35.48
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	23	21	$951.00	$339.38
52356 Crushing of stone of ureter with insertion of stent using an endoscope	23	20	$1788.31	$467.00
51702 Simple insertion of temporary bladder tube	19	11	$289.00	$69.42
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	16	16	$3205.00	$761.22
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	13	12	$1049.00	$62.32
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	13	13	$1428.00	$468.08
55700 Biopsy of prostate gland	12	12	$857.00	$261.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	7,500	21	$15.00	$6.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	499	357	$309.00	$114.47
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	491	56	$480.00	$138.11
99213 Established patient office or other outpatient visit, typically 15 minutes	417	309	$208.00	$79.21
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	228	23	$775.00	$218.03
51798 Ultrasound measurement of bladder capacity after voiding	193	170	$79.00	$11.19
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	182	182	$470.00	$172.70
52000 Diagnostic exam of bladder and urethra using an endoscope	156	144	$765.00	$228.12
51741 Electronic assessment of bladder emptying	156	142	$61.00	$10.26
51705 Removal of skin suture with change of bladder tube	108	13	$347.00	$101.86
51701 Insertion of temporary bladder tube	56	42	$211.00	$47.09
52287 Exam with injections of chemical for destruction of bladder using an endoscope	39	21	$1170.00	$390.61
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	38	23	$184.00	$33.79
74420 Imaging of urinary tract	31	27	$85.00	$27.00
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	23	23	$906.00	$298.13
52356 Crushing of stone of ureter with insertion of stent using an endoscope	21	21	$1787.99	$471.75
52204 Biopsy of the bladder using an endoscope	13	13	$1418.00	$420.10
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	13	13	$1360.00	$446.89
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	13	13	$1042.00	$61.82
55700 Biopsy of prostate gland	13	13	$816.00	$269.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	7,700	21	$14.00	$6.03
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	575	51	$480.00	$139.74
99213 Established patient office or other outpatient visit, typically 15 minutes	554	385	$208.00	$78.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	530	373	$309.00	$113.91
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	282	30	$660.00	$222.28
51798 Ultrasound measurement of bladder capacity after voiding	227	173	$79.00	$13.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	216	216	$470.00	$171.61
52000 Diagnostic exam of bladder and urethra using an endoscope	200	176	$765.00	$204.31
51741 Electronic assessment of bladder emptying	177	146	$61.00	$10.45
51705 Removal of skin suture with change of bladder tube	117	16	$347.00	$100.94
51701 Insertion of temporary bladder tube	69	57	$211.00	$46.06
51700 Simple bladder irrigation and/or instillation	65	13	$316.00	$80.17
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	47	30	$184.00	$33.41
52287 Exam with injections of chemical for destruction of bladder using an endoscope	38	21	$1170.00	$364.94
74420 Imaging of urinary tract	37	31	$85.00	$27.10
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	28	25	$906.00	$289.19
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	25	25	$3052.00	$770.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	24	$132.00	$48.03
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	22	21	$1001.77	$57.34
55700 Biopsy of prostate gland	19	19	$816.00	$263.28
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	16	$1942.92	$489.44
51702 Simple insertion of temporary bladder tube	16	12	$275.00	$67.07
52204 Biopsy of the bladder using an endoscope	15	15	$1418.00	$399.82
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	15	12	$1038.00	$253.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$310.00	$113.91
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	13	13	$1360.00	$420.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	9,000	24	$14.00	$6.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	636	468	$301.00	$111.25
99213 Established patient office or other outpatient visit, typically 15 minutes	553	409	$202.00	$75.84
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	479	41	$467.00	$139.21
51798 Ultrasound measurement of bladder capacity after voiding	233	193	$76.00	$17.12
52000 Diagnostic exam of bladder and urethra using an endoscope	228	201	$744.00	$175.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	217	217	$458.00	$168.56
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	210	24	$642.00	$214.42
51741 Electronic assessment of bladder emptying	204	175	$59.00	$10.97
51705 Removal of skin suture with change of bladder tube	107	16	$337.00	$96.22
51701 Insertion of temporary bladder tube	78	66	$205.00	$49.49
52287 Exam with injections of chemical for destruction of bladder using an endoscope	44	24	$1138.00	$331.67
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	36	25	$184.00	$32.94
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	26	26	$566.00	$213.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	25	25	$403.00	$145.06
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	23	23	$2970.00	$758.10
74420 Imaging of urinary tract	23	20	$82.00	$18.27
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	23	22	$1014.00	$63.26
76872 Ultrasound scan of pelvic region through rectum	20	20	$351.00	$103.74
55700 Biopsy of prostate gland	20	20	$794.00	$264.26
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	19	18	$881.00	$258.61
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	13	13	$1323.00	$390.27
52281 Dilation of bladder canal (urethra) using an endoscope	12	11	$997.00	$290.95
52356 Crushing of stone of ureter with insertion of stent using an endoscope	11	11	$1736.51	$450.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	4,500	17	$9.33	$5.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	799	537	$294.00	$110.62
99213 Established patient office or other outpatient visit, typically 15 minutes	406	302	$197.00	$75.56
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	358	33	$457.00	$135.55
52000 Diagnostic exam of bladder and urethra using an endoscope	218	195	$728.00	$172.41
51798 Ultrasound measurement of bladder capacity after voiding	217	170	$74.00	$20.61
51741 Electronic assessment of bladder emptying	202	165	$57.00	$11.21
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	177	22	$628.00	$208.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	171	171	$447.00	$167.04
51705 Removal of skin suture with change of bladder tube	97	17	$330.00	$94.42
51701 Insertion of temporary bladder tube	94	69	$200.00	$49.27
51700 Simple bladder irrigation and/or instillation	66	13	$300.00	$76.22
51702 Simple insertion of temporary bladder tube	60	18	$261.00	$66.32
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	30	30	$2908.00	$873.53
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	29	29	$553.00	$211.31
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	29	22	$184.00	$34.38
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	28	25	$862.00	$241.88
52001 Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope	27	26	$1295.00	$379.38
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	22	$393.00	$148.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	15	$125.00	$45.30
52287 Exam with injections of chemical for destruction of bladder using an endoscope	23	18	$1114.00	$326.37
74420 Imaging of urinary tract	20	20	$80.00	$18.19
55700 Biopsy of prostate gland	17	17	$777.00	$259.68
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	17	$1868.09	$451.65
52224 Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	16	14	$2551.00	$734.35
76872 Ultrasound scan of pelvic region through rectum	16	16	$343.00	$101.12
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	16	15	$993.00	$63.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$295.00	$111.61
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$382.00	$141.44

Medical Specialties & State Licenses

CMS Verified: 2020-03-20

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License CA A90492

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Urology

NUCC Taxonomy Code: 208800000X

State License VA 0101058329

Hospital & Practice Group Affiliations

Sutter Valley Medical Foundation

2800 L St, Sacramento, CA 958165616

Sutter Valley Medical Foundation

2825 Capitol Ave, Sacramento, CA 958166039

Phone: 9164546600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners

Elisabeth Abdin

Internal Medicine

NPI 1124391941

Laura Green , NP

Nurse Practitioner

NPI 1144329731

Nurse Practitioner

Alisa Manzano , MS, PT

Clinic/Center - Physical Therapy

NPI 1154864080

Master of Science, Physical Therapist

Dr. Edward Lee , MD

Internal Medicine

NPI 1164500898

Doctor of Medicine (M.D.)

Yasmine Jones , FNP

Nurse Practitioner

NPI 1205128857

Family Nurse Practitioner

Susan Gillespie , NP

Nurse Practitioner

NPI 1235462086

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 20, 2020

Urology (License #A90492 in CA)

✅

NPI Profile Active July 10, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location July 10, 2015

Registered at 2030 SUTTER PL, SUITE 1000, DAVIS, CA 956166212 (Tel: 5307505995)

📍

Updated Business Mailing Address July 10, 2015

Registered at 10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 958272539 (Tel: 8557710335)

👤

Provider Name / Credentials Updated July 10, 2015

Recorded as KENNETH FERGUSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2015

Urology (License #A90492 in CA)

🟢

Initial NPI Registration & Enumeration October 14, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1912996794

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 14, 2005

Last Update: March 20, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

10470 Old Placerville Rd, Suite 100

Sacramento, CA 958272539

Phone: 8557710335

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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