MEDICARE: KERN COUNTY HOSPITAL AUTHORITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician
2	282N00000X	General Acute Care Hospital	120000182	CA

General Provider Information

NPI Number	:	1548715063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERN COUNTY HOSPITAL AUTHORITY

Provider Business Mailing Address
First Line	:	1700 MOUNT VERNON AVE RM 1241
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93306-4018
Country	:	US
Telephone Number	:	661-326-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 STOCKDALE HWY STE 300
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93311-3611
Country	:	US
Telephone Number	:	661-664-2200
Fax Number	:	661-664-2202

Authorized Official
Title or Position	:	CHIEF AMBULATORY OFFICER
Name	:	RENEE VILLANUEVA
Credential	:
Telephone Number	:	661-326-2682

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	02/06/2025

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Directions to “KERN COUNTY HOSPITAL AUTHORITY ” Practice Location

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