Healthcare Provider Details

I. General information

NPI: 1134447733
Provider Name (Legal Business Name): STUART THOMAS YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 11/06/2021
Certification Date: 11/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD. MAIL CODE 117
LOS ANGELES CA
90073
US

IV. Provider business mailing address

11301 WILSHIRE BLVD. MAIL CODE 117
LOS ANGELES CA
90073
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3342
  • Fax:
Mailing address:
  • Phone: 310-268-3342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA110345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: