Healthcare Provider Details

I. General information

NPI: 1659407476
Provider Name (Legal Business Name): YIU FUN DEREK LEE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16388 COLIMA RD STE 203
HACIENDA HEIGHTS CA
91745-5525
US

IV. Provider business mailing address

16388 COLIMA RD STE 203
HACIENDA HEIGHTS CA
91745-5525
US

V. Phone/Fax

Practice location:
  • Phone: 626-369-1886
  • Fax: 626-369-2557
Mailing address:
  • Phone: 626-369-1886
  • Fax: 626-369-2557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG81110
License Number StateCA

VIII. Authorized Official

Name: DR. DEREK LEE
Title or Position: DR
Credential: M.D
Phone: 626-369-1886