1538296579 NPI number — DR. DIANE L KANE MD

Table of content: DR. DIANE L KANE MD (NPI 1538296579)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538296579 NPI number — DR. DIANE L KANE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANE
Provider First Name:
DIANE
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KANE
Provider Other First Name:
DIANE
Provider Other Middle Name:
L RUBIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1538296579
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5400 SUNSET DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80123-1422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-797-1012
Provider Business Mailing Address Fax Number:
303-797-1067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5555 E ARAPAHOE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80122-2312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-850-5894
Provider Business Practice Location Address Fax Number:
303-850-2149
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  37266 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011641 . This is a "KAISER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30289734 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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