Provider First Line Business Practice Location Address: 
2215 TRUXTUN AVE
    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: 
93301-3698
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
661-632-5000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/24/2021