Provider Demographics
NPI:1902835648
Name:BRETT V. KESLER, DPM, INC.
Entity Type:Organization
Organization Name:BRETT V. KESLER, DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:V
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:661-323-0403
Mailing Address - Street 1:2201 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3608
Mailing Address - Country:US
Mailing Address - Phone:661-323-0403
Mailing Address - Fax:661-323-2950
Practice Address - Street 1:2201 19TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3608
Practice Address - Country:US
Practice Address - Phone:661-323-0403
Practice Address - Fax:661-323-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4239213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ02467ZMedicare PIN
CA5699940001Medicare NSC