Provider Demographics
NPI:1427453695
Name:HIMMELMANN, RICHARD JR (DAC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:HIMMELMANN
Suffix:JR
Gender:M
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59-525 AKANOHO PL
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-9502
Mailing Address - Country:US
Mailing Address - Phone:808-778-8061
Mailing Address - Fax:
Practice Address - Street 1:91-2135 FORT WEAVER RD
Practice Address - Street 2:#150
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1940
Practice Address - Country:US
Practice Address - Phone:808-676-5331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-105171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist