Healthcare Provider Details

I. General information

NPI: 1376018846
Provider Name (Legal Business Name): OLAVE S YEE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3951 GRAND AVE
CHINO CA
91710-5429
US

IV. Provider business mailing address

15920 POMONA RINCON RD UNIT 6210
CHINO HILLS CA
91709-5529
US

V. Phone/Fax

Practice location:
  • Phone: 909-548-5355
  • Fax: 909-614-8083
Mailing address:
  • Phone: 949-784-9184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number34131TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: