Healthcare Provider Details

I. General information

NPI: 1639626757
Provider Name (Legal Business Name): YUEN YUN LEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25919 GADING RD
HAYWARD CA
94544-2725
US

IV. Provider business mailing address

400 E RIVULON BLVD STE 103
GILBERT AZ
85297-0096
US

V. Phone/Fax

Practice location:
  • Phone: 510-782-8424
  • Fax:
Mailing address:
  • Phone: 510-782-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: