Provider Demographics
NPI:1801019252
Name:BIMESTEFER, DAVID RANDALL (LAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RANDALL
Last Name:BIMESTEFER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:7200 E HAMPDEN AVE #103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3021
Mailing Address - Country:US
Mailing Address - Phone:303-698-2700
Mailing Address - Fax:303-758-2633
Practice Address - Street 1:3320 E ASBURY AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3605
Practice Address - Country:US
Practice Address - Phone:303-698-2700
Practice Address - Fax:303-757-1124
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO247171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist