Provider Demographics
NPI:1093753352
Name:STOBBE, KAI F (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KAI
Middle Name:F
Last Name:STOBBE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ROCKY MOUNTAIN AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9004
Mailing Address - Country:US
Mailing Address - Phone:970-495-7421
Mailing Address - Fax:970-203-7179
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE STE 340
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-495-7421
Practice Address - Fax:970-203-7179
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1383363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20854323Medicaid
WY425OtherWYOMING MEDICAL LICENSE
CO1383OtherCOLORADO MEDICAL LICENSE
CO1383OtherCOLORADO MEDICAL LICENSE
COP61184Medicare UPIN
COC468368Medicare ID - Type Unspecified