Healthcare Provider Details

I. General information

NPI: 1487059366
Provider Name (Legal Business Name): KRISTEN YEE, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11820 DUBLIN BLVD
DUBLIN CA
94568-2830
US

IV. Provider business mailing address

PO BOX 650
WINDSOR CA
95492-0650
US

V. Phone/Fax

Practice location:
  • Phone: 258-750-7009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA91099
License Number StateCA

VIII. Authorized Official

Name: KRISTEN SHUI-CHUN YEE
Title or Position: PRESIDENT
Credential: MD
Phone: 916-201-3435