Provider First Line Business Practice Location Address:
4900 CALIFORNIA AVENUE SUITE 400B
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-630-7045
Provider Business Practice Location Address Fax Number:
661-459-1944
Provider Enumeration Date:
10/25/2013