Provider Demographics
NPI:1558472159
Name:DRENGLER, KAY E (DO)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:E
Last Name:DRENGLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:10058 WOLF RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949-8194
Practice Address - Country:US
Practice Address - Phone:530-268-0847
Practice Address - Fax:530-268-8843
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX73820Medicaid
020A73820Medicare ID - Type Unspecified
CA00AX73820Medicaid