Provider First Line Business Practice Location Address:
10348 N BAIRD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93730-4711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-392-0340
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2026