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General NPI Number Information
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NPI Number | 1063465680
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Entity Type | Organization
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Legal Business Name | KERN & ASSOC PT
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2901 WILSHIRE BLVD 440
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City | SANTA MONICA
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State | CA
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Zip | 90403-4901
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Country | US
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Telephone | 310-315-9711
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Fax | 310-315-9349
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Provider Business Mailing Address
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Address Line | 2901 WILSHIRE BLVD 440
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City | SANTA MONICA
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State | CA
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Zip | 90403-4901
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Country | US
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Telephone | 310-315-9711
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Fax | 310-315-9349
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Authorized Official
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Title or Position | OWNER
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Name | MRS. REBECCA W KERN
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Credential | PT DPT OCS
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Telephone | 310-315-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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