Healthcare Provider Details

I. General information

NPI: 1700064391
Provider Name (Legal Business Name): MARK ALAN KABAT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 POTOMAC ST STE 123
AURORA CO
80011-6743
US

IV. Provider business mailing address

750 POTOMAC ST STE 123
AURORA CO
80011-6743
US

V. Phone/Fax

Practice location:
  • Phone: 720-477-4758
  • Fax: 832-869-4853
Mailing address:
  • Phone: 720-477-4758
  • Fax: 832-869-4853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR44400
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: