Provider Demographics
NPI:1437324423
Name:BURTON, KYLE W (LAC, DAOM)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:W
Last Name:BURTON
Suffix:
Gender:M
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 ULULANI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4430
Mailing Address - Country:US
Mailing Address - Phone:310-980-9764
Mailing Address - Fax:
Practice Address - Street 1:658 ULULANI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4430
Practice Address - Country:US
Practice Address - Phone:310-980-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11336171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist