Provider Demographics
NPI:1801097365
Name:KOBAYASHI, AI LAN D (MD)
Entity type:Individual
Prefix:DR
First Name:AI LAN
Middle Name:D
Last Name:KOBAYASHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E GOLD COAST RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4194
Mailing Address - Country:US
Mailing Address - Phone:402-592-1700
Mailing Address - Fax:402-592-3335
Practice Address - Street 1:401 E GOLD COAST RD
Practice Address - Street 2:SUITE 325
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4194
Practice Address - Country:US
Practice Address - Phone:402-592-1700
Practice Address - Fax:402-592-3335
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15261208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics