Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 279191-1 | NY |
N | 111NI0900X | Internist | 279191-1 | NY |
N | 207R00000X | Internist | A125507 | CA |
N | 111NI0900X | Internist | A125507 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | 279191 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | A125507 | CA |
NPI | 1174803431 |
---|---|
Provider Name | Dr. Kara Yaeko Kerns |
First Address | Newport Beach, CA 92659-8589 |
Second Address | Newport Beach, CA 92663-4162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2011 |
Last Update Date | 18/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174803431 | NPI (01) |