Provider Demographics
NPI:1043784952
Name:KAY KOBE DC
Entity Type:Organization
Organization Name:KAY KOBE DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-945-3211
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:SHASTA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:96019-0175
Mailing Address - Country:US
Mailing Address - Phone:530-945-3211
Mailing Address - Fax:530-275-8662
Practice Address - Street 1:4221 SHASTA DAM BLVD
Practice Address - Street 2:
Practice Address - City:SHASTA LAKE
Practice Address - State:CA
Practice Address - Zip Code:96019-9423
Practice Address - Country:US
Practice Address - Phone:530-275-1585
Practice Address - Fax:530-275-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty