MEDICARE: MRS. KAYE KAROL DRENNAN M.D.

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	2085B0100X	Body Imaging Physician	G50868	CA
2	2085N0700X	Neuroradiology Physician	G50868	CA
3	2085N0904X	Nuclear Radiology Physician	G50868	CA
4	2085R0202X	Diagnostic Radiology Physician	G50868	CA
5	2085R0203X	Therapeutic Radiology Physician	G50868	CA
6	2085R0204X	Vascular & Interventional Radiology Physician	G50868	CA
7	2085R0205X	Radiological Physics Physician	G50868	CA

General Provider Information

NPI Number	:	1619974714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAYE KAROL DRENNAN M.D.

Provider Business Mailing Address
First Line	:	P,O, BOX 255228
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-5228
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:	916-920-4434

Provider Business Practice Location Address
First Line	:	2800 L. STREET
Second Line	:	SUITE 610
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-5616
Country	:	US
Telephone Number	:	916-733-4400
Fax Number	:	916-454-6926

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/04/2011

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