Provider Demographics
NPI:1336231075
Name:YIM, KATHLEEN WAI HING (DC DOCTOR OF CHIROPR)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:WAI HING
Last Name:YIM
Suffix:
Gender:F
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 AULIKE ST
Mailing Address - Street 2:STE #302
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:808-263-3322
Mailing Address - Fax:
Practice Address - Street 1:30 AULIKE STE
Practice Address - Street 2:STE #302
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-263-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC801111N00000X
CADC26260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U78172Medicare UPIN