Healthcare Provider Details

I. General information

NPI: 1538186432
Provider Name (Legal Business Name): KENT JAMES FARNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 WILLOW ST
ALAMEDA CA
94501-4328
US

IV. Provider business mailing address

5528 PACHECO BLVD BLDG A
PACHECO CA
94553-5157
US

V. Phone/Fax

Practice location:
  • Phone: 510-522-4130
  • Fax: 510-522-3202
Mailing address:
  • Phone: 925-363-8170
  • Fax: 925-363-8178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG41657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: