Provider First Line Business Practice Location Address:
500 OLD RIVER RD STE 170
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:
93311-9505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-347-6614
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2026