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General NPI Number Information
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NPI Number | 1528149903
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Entity Type | Organization
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Legal Business Name | KERN PRIMARY CARE MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2203 19TH ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3608
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Country | US
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Telephone | 661-633-2009
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Fax | 661-633-1401
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Provider Business Mailing Address
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Address Line | PO BOX 21717
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City | BAKERSFIELD
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State | CA
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Zip | 93390-1717
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Country | US
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Telephone | 661-633-2009
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Fax | 661-633-1401
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROSEMARIE B. DELLICA
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Credential | M.D.
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Telephone | 661-633-2009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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