Healthcare Provider Details

I. General information

NPI: 1114081981
Provider Name (Legal Business Name): YIU FUN DEREK LEE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16388 COLIMA RD STE 206
HACIENDA HEIGHTS CA
91745-5525
US

IV. Provider business mailing address

16388 COLIMA RD STE 206
HACIENDA HEIGHTS CA
91745-5525
US

V. Phone/Fax

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

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:
Title or Position:
Credential:
Phone: