Provider Demographics
NPI:1912931197
Name:KOBE, CHRISTOPHER LEWIS (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEWIS
Last Name:KOBE
Suffix:
Gender:M
Credentials:DC
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 776
Mailing Address - Street 2:
Mailing Address - City:SHASTA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:96019-0776
Mailing Address - Country:US
Mailing Address - Phone:530-275-1585
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
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16454111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1568496743OtherPARTNER KAY KOBE DC NPI
CADC0164540Medicaid
CAZZZ27906ZOtherGROUP MEDICARE
CA1235152364OtherGROUP NPI
CAZZZ08124ZOtherBLUE SHIELD/CROSS GROUP#
CA1568496743OtherPARTNER KAY KOBE DC NPI
CAT06144Medicare UPIN