Provider Demographics
NPI:1750477261
Name:KIMURA, LINDSEY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:JOHN
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 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:STE 215
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5310
Mailing Address - Country:US
Mailing Address - Phone:808-487-1575
Mailing Address - Fax:808-487-1585
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 211
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-487-1575
Practice Address - Fax:808-487-1585
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000QCBZHMedicare ID - Type Unspecified