Provider Demographics
NPI:1417456542
Name:KERN RADIOLOGY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:KERN RADIOLOGY MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:STURZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-326-9600
Mailing Address - Street 1:4500 MORNING DR STE 204
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7277
Mailing Address - Country:US
Mailing Address - Phone:661-326-9600
Mailing Address - Fax:661-334-3065
Practice Address - Street 1:501 MUNZER ST STE A
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-2042
Practice Address - Country:US
Practice Address - Phone:661-326-9600
Practice Address - Fax:661-334-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty