Healthcare Provider Details

I. General information

NPI: 1366798134
Provider Name (Legal Business Name): CRYSTAL YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 PACIFICA STE 340
IRVINE CA
92618-3329
US

IV. Provider business mailing address

114 PACIFICA STE 340
IRVINE CA
92618-3329
US

V. Phone/Fax

Practice location:
  • Phone: 949-390-9010
  • Fax: 949-331-1445
Mailing address:
  • Phone: 949-390-9010
  • Fax: 949-331-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ7517
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA132768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: