Provider Demographics
NPI:1518024793
Name:KIMURA, PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:KIMURA
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 1:3979 E ARAPAHOE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2072
Mailing Address - Country:US
Mailing Address - Phone:303-694-2700
Mailing Address - Fax:303-694-4454
Practice Address - Street 1:3979 E ARAPAHOE RD
Practice Address - Street 2:STE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2072
Practice Address - Country:US
Practice Address - Phone:303-694-2700
Practice Address - Fax:303-694-4454
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COM37395OtherWORKMEN'S COMP.
COM37395OtherWORKMEN'S COMP.
COU38959Medicare UPIN