Provider First Line Business Practice Location Address:
5701 YOUNG ST STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-8897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
883-831-8946
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2025