Provider Demographics
NPI:1124378096
Name:LESTER KC YIM MD LLC
Entity Type:Organization
Organization Name:LESTER KC YIM MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:K C
Authorized Official - Last Name:YIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-377-1390
Mailing Address - Street 1:PO BOX 25668
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-0668
Mailing Address - Country:US
Mailing Address - Phone:808-536-0314
Mailing Address - Fax:808-536-0320
Practice Address - Street 1:1900 PIIMAUNA PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2614
Practice Address - Country:US
Practice Address - Phone:808-377-1390
Practice Address - Fax:808-377-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty