Provider Demographics
NPI: | 1710612965 |
---|---|
Name: | KERN COUNTY HOSPITAL AUTHORITY |
Entity Type: | Organization |
Organization Name: | KERN COUNTY HOSPITAL AUTHORITY |
Other - Org Name: | KERN MEDICAL CENTER |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANDY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CANTU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 661-326-2104 |
Mailing Address - Street 1: | 1700 MOUNT VERNON AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | BAKERSFIELD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 93306-4018 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 661-326-2000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2222 19TH ST |
Practice Address - Street 2: | |
Practice Address - City: | BAKERSFIELD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 93301-3609 |
Practice Address - Country: | US |
Practice Address - Phone: | 661-326-2000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-07-21 |
Last Update Date: | 2023-05-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | ||
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty |