Mckenna, Kathleen Moira

Mckenna, Kathleen Moira is an individual health care provider with primary practice located at 100 S San Mateo Dr , San Mateo CA 94401-3805. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Mckenna, Kathleen Moira can be contacted via phone (650) 696-4515.

Contact Information

Primary practice address
100 S San Mateo Dr San Mateo CA 94401-3805
Phone: (650) 696-4515
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G67306 California

Profile Details

NPI number 1699711358
LBN Legal business name Mckenna, Kathleen Moira
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Mar 19th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699711358 NPPES
California MEDICAID 00G673060
California Other 300121871

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