Healthcare Provider Details

I. General information

NPI: 1972530350
Provider Name (Legal Business Name): GARY G YEE RD, CDE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E TEMPLE ST
LOS ANGELES CA
90012-3328
US

IV. Provider business mailing address

536 N PAGEANT DR UNIT C
ORANGE CA
92869-2573
US

V. Phone/Fax

Practice location:
  • Phone: 213-253-2677
  • Fax:
Mailing address:
  • Phone: 213-253-2677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: