Healthcare Provider Details

I. General information

NPI: 1740685999
Provider Name (Legal Business Name): LAURA YEE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 06/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27020 ALICIA PKWY SUITE G
LAGUNA NIGUEL CA
92677-3420
US

IV. Provider business mailing address

24411 HEALTH CENTER DR STE 350
LAGUNA HILLS CA
92653-3687
US

V. Phone/Fax

Practice location:
  • Phone: 949-707-5734
  • Fax:
Mailing address:
  • Phone: 949-457-7900
  • Fax: 949-588-8719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number52108
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: