Provider Demographics
NPI:1174803431
Name:KERNS, KARA YAEKO (MD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:YAEKO
Last Name:KERNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:Y
Other - Last Name:ISHIKAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3589
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-8589
Mailing Address - Country:US
Mailing Address - Phone:657-241-3600
Mailing Address - Fax:657-241-7708
Practice Address - Street 1:1 HOAG DR BLDG 41
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4162
Practice Address - Country:US
Practice Address - Phone:949-764-7647
Practice Address - Fax:657-241-7720
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125507207R00000X, 207RH0002X
NY279191-1207R00000X
NY279191207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174803431OtherNPI