Healthcare Provider Details

I. General information

NPI: 1235601642
Provider Name (Legal Business Name): DR. MICHAEL YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2018
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3828 DELMAS TER
CULVER CITY CA
90232-2713
US

IV. Provider business mailing address

5940 OAK AVE UNIT 401
TEMPLE CITY CA
91780-4415
US

V. Phone/Fax

Practice location:
  • Phone: 310-202-4710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number78582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: