Healthcare Provider Details

I. General information

NPI: 1972986800
Provider Name (Legal Business Name): RICKUL VARSHNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6670 ALTON PKWY HEAD AND NECK SURGERY, KAISER PERMANENTE
IRVINE CA
92618-3734
US

IV. Provider business mailing address

6670 ALTON PKWY HEAD AND NECK SURGERY, KAISER PERMANENTE
IRVINE CA
92618-3734
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-2800
  • Fax:
Mailing address:
  • Phone: 888-988-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number137482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: