Provider Demographics
NPI:1538296579
Name:KANE, DIANE L (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:L
Last Name:KANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:L RUBIN
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5400 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1422
Mailing Address - Country:US
Mailing Address - Phone:303-797-1012
Mailing Address - Fax:303-797-1067
Practice Address - Street 1:5555 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2312
Practice Address - Country:US
Practice Address - Phone:303-850-5894
Practice Address - Fax:303-850-2149
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37266208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
011641OtherKAISER-COMMERCIAL NUMBER
CO30289734Medicaid
COH30295Medicare UPIN
CO30289734Medicaid
COCOA104974Medicare PIN