Healthcare Provider Details

I. General information

NPI: 1801083290
Provider Name (Legal Business Name): BRUCE ARNOLD YEE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 466 BOX 3
FPO AP
96595-0001
US

IV. Provider business mailing address

PSC 466 BOX 3
FPO AP
96595-0001
US

V. Phone/Fax

Practice location:
  • Phone: 315-370-4216
  • Fax:
Mailing address:
  • Phone: 315-370-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A10147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: