Healthcare Provider Details

I. General information

NPI: 1154347615
Provider Name (Legal Business Name): KYLA AI-LAN YEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4053 LONE TREE WAY #101
ANTIOCH CA
94531-6200
US

IV. Provider business mailing address

PO BOX 255849
SACRAMENTO CA
95865-5849
US

V. Phone/Fax

Practice location:
  • Phone: 925-756-3400
  • Fax: 925-757-0849
Mailing address:
  • Phone: 916-854-6975
  • Fax: 916-854-6844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA81473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: