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NPI Code Detail

MEDICARE: MR. DAVID RANDALL BIMESTEFER LAC

MEDICARE: MR. DAVID RANDALL BIMESTEFER LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist247CO

General Provider Information

NPI Number : 1801019252
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID RANDALL BIMESTEFER LAC
Provider Business Mailing Address
First Line : 7200 E HAMPDEN AVE #103
Second Line :
City : DENVER
State : CO
Zip : 80224-3021
Country : US
Telephone Number : 303-698-2700
Fax Number : 303-758-2633
Provider Business Practice Location Address
First Line : 3320 E ASBURY AVE
Second Line :
City : DENVER
State : CO
Zip : 80210-3605
Country : US
Telephone Number : 303-698-2700
Fax Number : 303-757-1124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 09/29/2015

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