Provider First Line Business Practice Location Address:
42304 BALD MOUNTAIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBERRY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93602-9784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-449-3449
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2026