Healthcare Provider Details

I. General information

NPI: 1659792158
Provider Name (Legal Business Name): KERN NEUROSURGICAL INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 16TH ST STE 407
BAKERSFIELD CA
93301-3454
US

IV. Provider business mailing address

2323 16TH ST STE 407
BAKERSFIELD CA
93301-3454
US

V. Phone/Fax

Practice location:
  • Phone: 818-294-2657
  • Fax:
Mailing address:
  • Phone: 818-294-2657
  • Fax: 661-843-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA96203
License Number StateCA

VIII. Authorized Official

Name: JAN MATHIAS ECKERMANN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-843-7880