Provider First Line Business Practice Location Address:
6309 S HALF MOON DR APT B
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:
93309-7930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-734-7120
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2025