Provider Demographics
NPI:1710091749
Name:KITT, SEE-RUERN S (MD)
Entity Type:Individual
Prefix:
First Name:SEE-RUERN
Middle Name:S
Last Name:KITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 19TH STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-325-2448
Mailing Address - Fax:661-325-7425
Practice Address - Street 1:2222 19TH STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-325-2448
Practice Address - Fax:661-325-7425
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41262207K00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C412620Medicaid
CA00C412620Medicaid
CAZZZ97455ZMedicare ID - Type Unspecified