Healthcare Provider Details
I. General information
NPI: 1437972205
Provider Name (Legal Business Name): DR WAI-YEE LI, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2024
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
624 W DUARTE RD STE 101
ARCADIA CA
91007-9257
US
IV. Provider business mailing address
530 SOUTH LAKE AVENUE, STE 530
PASADENA CA
91101-3515
US
V. Phone/Fax
- Phone: 626-888-9728
- Fax: 626-445-2738
- Phone: 626-888-9728
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WAI-YEE
LI
Title or Position: CEO
Credential: MD PHD
Phone: 626-888-9728