Provider First Line Business Practice Location Address:
15520 DONOSTIA ST
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:
93314-4377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-201-3275
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2023