Provider Demographics
NPI:1659792158
Name:KERN NEUROSURGICAL INSTITUTE, INC
Entity Type:Organization
Organization Name:KERN NEUROSURGICAL INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MATHIAS
Authorized Official - Last Name:ECKERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-843-7880
Mailing Address - Street 1:2323 16TH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3454
Mailing Address - Country:US
Mailing Address - Phone:818-294-2657
Mailing Address - Fax:661-843-7882
Practice Address - Street 1:2323 16TH ST STE 407
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3454
Practice Address - Country:US
Practice Address - Phone:818-294-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96203207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty