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General NPI Number Information
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NPI Number | 1972857464
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Entity Type | Organization
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Legal Business Name | MARC M KERNER M D APC
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 18350 ROSCOE BLVD SUITE 318
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4109
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Country | US
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Telephone | 818-349-0600
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Fax | 818-993-0937
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Provider Business Mailing Address
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Address Line | 18350 ROSCOE BLVD SUITE 318
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4109
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Country | US
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Telephone | 818-349-0600
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Fax | 818-993-0937
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARC KERNER
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Credential | M.D.
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Telephone | 818-349-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G69740
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License Number State | CA
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