Provider Demographics
NPI:1538186432
Name:FARNEY, KENT JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:JAMES
Last Name:FARNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5528 PACHECO BLVD BLDG A
Mailing Address - Street 2:
Mailing Address - City:PACHECO
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5157
Mailing Address - Country:US
Mailing Address - Phone:925-363-8170
Mailing Address - Fax:925-363-8178
Practice Address - Street 1:888 WILLOW ST
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4328
Practice Address - Country:US
Practice Address - Phone:510-522-4130
Practice Address - Fax:510-522-3202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2011-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG41657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG41657OtherMEDICAL LICENSE
A48648Medicare UPIN
48648Medicare ID - Type Unspecified