Healthcare Provider Details
I. General information
NPI: 1366290462
Provider Name (Legal Business Name): KERN SURGICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2024
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 TRUXTUN AVE
BAKERSFIELD CA
93301-5013
US
IV. Provider business mailing address
2020 TRUXTUN AVE
BAKERSFIELD CA
93301-5013
US
V. Phone/Fax
- Phone: 661-570-2020
- Fax:
- Phone: 661-570-2020
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JERRY
CHERIYAN
Title or Position: PROVIDER
Credential: MD
Phone: 661-570-2020