Healthcare Provider Details

I. General information

NPI: 1679689061
Provider Name (Legal Business Name): BRIAN R. KAYE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 TELEGRAPH AVE SUITE 120
BERKELEY CA
94705-1192
US

IV. Provider business mailing address

10470 OLD PLACERVILLE RD
SACRAMENTO CA
95827-2539
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-2529
  • Fax: 510-649-1238
Mailing address:
  • Phone: 916-854-6666
  • Fax: 916-854-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG53046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: