Provider First Line Business Practice Location Address:
5121 STOCKDALE HWY STE 210
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:
93309-2664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-392-8202
Provider Business Practice Location Address Fax Number:
661-412-0363
Provider Enumeration Date:
04/20/2026