Individual
KEVIN X MCKENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 EXPOSITION BLVD BLDG 700, SACRAMENTO, CA 95815-4314
(916) 736-3408
(916) 233-4171
Mailing address
1111 EXPOSITION BLVD, BLDG 700, SACRAMENTO, CA 95815-4300
(916) 736-3399
(916) 233-4171
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
G40176
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040003543
RR MEDICARE PIN
CA
Enumeration date
05/24/2005
Last updated
10/04/2018
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