Healthcare Provider Details

I. General information

NPI: 1922578822
Provider Name (Legal Business Name): KERN COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 Q ST
BAKERSFIELD CA
93301-1657
US

IV. Provider business mailing address

1700 MOUNT VERNON AVE RM 1241
BAKERSFIELD CA
93306-4018
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2000
  • Fax:
Mailing address:
  • Phone: 661-326-2000
  • Fax: 661-326-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANDY CANTU
Title or Position: CFO
Credential:
Phone: 661-326-2104