Provider Demographics
NPI:1467795161
Name:KERN MEDICAL CENTER
Entity Type:Organization
Organization Name:KERN MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORNADO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-326-5411
Mailing Address - Street 1:2316 D ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3731
Mailing Address - Country:US
Mailing Address - Phone:810-624-6366
Mailing Address - Fax:
Practice Address - Street 1:1700 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-4018
Practice Address - Country:US
Practice Address - Phone:661-326-5411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural