Provider First Line Business Practice Location Address:
2815 S H ST APT 4
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:
93304-5651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-863-7087
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2026