Provider First Line Business Practice Location Address:
5701 YOUNG ST STE 301
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:
93311-8897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-797-0580
Provider Business Practice Location Address Fax Number:
661-836-5007
Provider Enumeration Date:
04/16/2026