Basic Information
Provider Information
NPI: 1124378096
EntityType: 2
ReplacementNPI:  
OrganizationName: LESTER KC YIM MD LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 25668
Address2:  
City: HONOLULU
State: HI
PostalCode: 968250668
CountryCode: US
TelephoneNumber: 8085360314
FaxNumber: 8085360320
Practice Location
Address1: 1900 PIIMAUNA PL
Address2:  
City: HONOLULU
State: HI
PostalCode: 968212614
CountryCode: US
TelephoneNumber: 8083771390
FaxNumber: 8083771390
Other Information
ProviderEnumerationDate: 09/18/2012
LastUpdateDate: 09/18/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: YIM
AuthorizedOfficialFirstName: LESTER
AuthorizedOfficialMiddleName: K C
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 8083771390
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD-8185HIY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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