Healthcare Provider Details

I. General information

NPI: 1437324423
Provider Name (Legal Business Name): KYLE W BURTON L.AC., DAOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 ULULANI ST
KAILUA HI
96734-4430
US

IV. Provider business mailing address

658 ULULANI ST
KAILUA HI
96734-4430
US

V. Phone/Fax

Practice location:
  • Phone: 310-980-9764
  • Fax:
Mailing address:
  • Phone: 310-980-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: