Provider Demographics
NPI:1710406459
Name:KERN ANESTHESIA ASSOCIATES, INC.
Entity Type:Organization
Organization Name:KERN ANESTHESIA ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-861-0011
Mailing Address - Street 1:21901 COTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-7110
Mailing Address - Country:US
Mailing Address - Phone:661-861-0011
Mailing Address - Fax:661-465-4150
Practice Address - Street 1:21901 COTTONWOOD CT
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-7110
Practice Address - Country:US
Practice Address - Phone:661-861-0011
Practice Address - Fax:661-465-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA4086207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANA4086OtherSTATE LICENSE
CARN509823OtherSTATE LICENSE