Healthcare Provider Details

I. General information

NPI: 1285643767
Provider Name (Legal Business Name): KUERSTEN MEDICAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 WASHINGTON ST
RED BLUFF CA
96080-3321
US

IV. Provider business mailing address

PO BOX 496084
REDDING CA
96049-6084
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-2420
  • Fax: 530-528-8640
Mailing address:
  • Phone: 530-241-0473
  • Fax: 530-241-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARTIN KUERSTEN
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 530-528-2420