Provider Demographics
NPI:1437174869
Name:HERSH, NEIL KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:KENNETH
Last Name:HERSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6659 MING AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3446
Mailing Address - Country:US
Mailing Address - Phone:661-831-0001
Mailing Address - Fax:661-831-0101
Practice Address - Street 1:6659 MING AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3446
Practice Address - Country:US
Practice Address - Phone:661-831-0001
Practice Address - Fax:661-831-0101
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58484207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G584840Medicare ID - Type Unspecified
CAE82335Medicare UPIN