Healthcare Provider Details

I. General information

NPI: 1508285693
Provider Name (Legal Business Name): VARUN VARADARAJAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 EXPOSITION BLVD BLDG 700
SACRAMENTO CA
95815-4314
US

IV. Provider business mailing address

1111 EXPOSITION BLVD BLDG 700
SACRAMENTO CA
95815-4314
US

V. Phone/Fax

Practice location:
  • Phone: 916-736-3399
  • Fax: 916-736-3350
Mailing address:
  • Phone: 916-736-3399
  • Fax: 916-736-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberA188996
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDR.0065880
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: