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NPI Code Detail

MEDICARE: KERN RADIOLOGY MEDICAL GROUP, INC

MEDICARE: KERN RADIOLOGY MEDICAL GROUP, INC
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720023997
Entity Type Code : Organization
Provider Name (Legal Business Name) : KERN RADIOLOGY MEDICAL GROUP, INC
Provider Business Mailing Address
First Line : 2301 BAHAMAS DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0663
Country : US
Telephone Number : 661-322-9958
Fax Number : 661-325-1725
Provider Business Practice Location Address
First Line : 2301 BAHAMAS DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0663
Country : US
Telephone Number : 661-322-9958
Fax Number : 661-325-1725
Authorized Official
Title or Position : CEO
Name : JERRY STURZ
Credential :
Telephone Number : 661-326-9600
Provider Enumeration Date : 06/19/2006
Last Update Date : 09/12/2017

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Directions to “KERN RADIOLOGY MEDICAL GROUP, INC ” Practice Location

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