Healthcare Provider Details

I. General information

NPI: 1720377070
Provider Name (Legal Business Name): KHIN SU YEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 N 1ST ST STE 119
FRESNO CA
93710-3947
US

IV. Provider business mailing address

373 E SHAW AVE STE 136
FRESNO CA
93710-7609
US

V. Phone/Fax

Practice location:
  • Phone: 559-540-7171
  • Fax: 559-540-7175
Mailing address:
  • Phone: 559-540-7171
  • Fax: 559-540-7175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA119019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: