Provider First Line Business Practice Location Address:
1230 FAIRWAY DR
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:
93309-2422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-696-2726
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2026