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General NPI Number Information
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NPI Number | 1568496743
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Entity Type | Individual
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Provider Name | KAY ELLEN KOBE D.C.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 4221 SHASTA DAM BLVD
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City | SHASTA LAKE
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State | CA
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Zip | 96019-9423
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Country | US
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Telephone | 530-275-1585
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Fax | 530-275-8662
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Provider Business Mailing Address
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Address Line | PO BOX 776
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City | SHASTA LAKE
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State | CA
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Zip | 96019-0776
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Country | US
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Telephone | 530-275-1585
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Fax | 530-275-8662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 17457
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License Number State | CA
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