Provider Demographics
NPI:1487175642
Name:KERN RURAL WELLNESS CENTERS, INC.
Entity type:Organization
Organization Name:KERN RURAL WELLNESS CENTERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-910-2407
Mailing Address - Street 1:146 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:ARVIN
Mailing Address - State:CA
Mailing Address - Zip Code:93203-1014
Mailing Address - Country:US
Mailing Address - Phone:661-855-4468
Mailing Address - Fax:
Practice Address - Street 1:1149 7TH ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-1819
Practice Address - Country:US
Practice Address - Phone:661-910-6890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KERN RURAL WELLNESS CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA9453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty