Healthcare Provider Details

I. General information

NPI: 1710543491
Provider Name (Legal Business Name): MR. WING H YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 SIERRA ST
KINGSBURG CA
93631-1512
US

IV. Provider business mailing address

929 SIERRA ST
KINGSBURG CA
93631-1512
US

V. Phone/Fax

Practice location:
  • Phone: 559-897-0290
  • Fax:
Mailing address:
  • Phone: 559-897-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: