Individual
ELA FIESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
323 CAMPUS DR, ARVIN, CA 93203-1047
(661) 854-4475
Mailing address
2804 TYLER ST, BAKERSFIELD, CA 93309-6124
(661) 348-1443
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
50712
CA
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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