Provider First Line Business Practice Location Address:
4000 PHYSICIANS BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-5839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-4885
Provider Business Practice Location Address Fax Number:
661-327-1430
Provider Enumeration Date:
08/30/2006