Provider Demographics
NPI:1841265402
Name:LAI, KANE SAM (MD)
Entity type:Individual
Prefix:DR
First Name:KANE
Middle Name:SAM
Last Name:LAI
Suffix:
Gender:
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:PO BOX 101703
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-1703
Mailing Address - Country:US
Mailing Address - Phone:720-443-2820
Mailing Address - Fax:866-381-8499
Practice Address - Street 1:2820 STONINGTON CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-8015
Practice Address - Country:US
Practice Address - Phone:720-443-2820
Practice Address - Fax:866-381-8499
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42334207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO51658038Medicaid
COCO40565Medicare PIN
CO51658038Medicaid
COI02920Medicare UPIN