Healthcare Provider Details

I. General information

NPI: 1801328802
Provider Name (Legal Business Name): KENNETH JUSTIN VARNES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 34TH ST STE 100
BAKERSFIELD CA
93301-2307
US

IV. Provider business mailing address

625 34TH ST STE 100
BAKERSFIELD CA
93301-2307
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax: 661-368-0618
Mailing address:
  • Phone: 833-678-2781
  • Fax: 661-368-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA163829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: