Provider First Line Business Practice Location Address:
4000 PHYSICIAN'S BLVD
Provider Second Line Business Practice Location Address:
BUILDING E, SUITE 211
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-401-2000
Provider Business Practice Location Address Fax Number:
661-401-2015
Provider Enumeration Date:
09/26/2005