Provider Demographics
NPI:1619974714
Name:DRENNAN, KAYE KAROL (MD)
Entity Type:Individual
Prefix:MRS
First Name:KAYE
Middle Name:KAROL
Last Name:DRENNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAYE
Other - Middle Name:KAROL
Other - Last Name:LOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P,O, BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:916-920-4434
Practice Address - Street 1:2800 L. STREET
Practice Address - Street 2:SUITE 610
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5616
Practice Address - Country:US
Practice Address - Phone:916-733-4400
Practice Address - Fax:916-454-6926
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG508682085B0100X, 2085N0700X, 2085N0904X, 2085R0202X, 2085R0203X, 2085R0204X, 2085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508680Medicare ID - Type Unspecified
A89924Medicare UPIN