Healthcare Provider Details

I. General information

NPI: 1508507393
Provider Name (Legal Business Name): BRIAN MICHAEL YEE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26672 PORTOLA PKWY STE 104
FOOTHILL RANCH CA
92610-1773
US

IV. Provider business mailing address

26672 PORTOLA PKWY STE 104
FOOTHILL RANCH CA
92610-1773
US

V. Phone/Fax

Practice location:
  • Phone: 949-557-0748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: