Individual
JOHN A KERMEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-1234
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A6669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX66690
—
CA
Enumeration date
05/11/2006
Last updated
07/09/2007
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