MEDICARE: CHARLES BRENNAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	34642	CA

General Provider Information

NPI Number	:	1568013407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES BRENNAN DC

Provider Business Mailing Address
First Line	:	5700 J ST STE A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3956
Country	:	US
Telephone Number	:	707-208-0646
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 J ST STE A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3956
Country	:	US
Telephone Number	:	707-208-0646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	01/05/2026

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Directions to “ CHARLES BRENNAN DC” Practice Location

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