Healthcare Provider Details

I. General information

NPI: 1801019252
Provider Name (Legal Business Name): DAVID RANDALL BIMESTEFER LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 E ASBURY AVE
DENVER CO
80210-3605
US

IV. Provider business mailing address

7200 E HAMPDEN AVE #103
DENVER CO
80224-3021
US

V. Phone/Fax

Practice location:
  • Phone: 303-698-2700
  • Fax: 303-757-1124
Mailing address:
  • Phone: 303-698-2700
  • Fax: 303-758-2633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number247
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: