Healthcare Provider Details

I. General information

NPI: 1992609028
Provider Name (Legal Business Name): ISAAC KIM CRNA INC., A PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 34TH ST
BAKERSFIELD CA
93301-2237
US

IV. Provider business mailing address

13047 ANDY ST
CERRITOS CA
90703-6120
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4647
  • Fax:
Mailing address:
  • Phone: 562-896-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ISAAC Y KIM
Title or Position: PRESIDENT
Credential: CRNA
Phone: 562-896-8241