Provider First Line Business Practice Location Address:
5500 MING AVE STE 128
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:
93309-4619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-863-2700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2025