Individual
MR. MARK BRIEN KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5176 HILL RD E, SUTTER-LAKESIDE HOSPITAL, ATTN: EMERGENCY DEPARTMENT, LAKEPORT, CA 95453-6300
(707) 262-5017
Mailing address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 384-7033
(970) 384-8174
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
23128
CA
363AM0700X
Medical Physician Assistant
Primary
PA.0005001
CO
Other
Enumeration date
09/11/2013
Last updated
01/03/2022
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