Provider First Line Business Practice Location Address: 
10700 ENGER 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: 
93312-3231
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
661-578-2726
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/18/2025