Healthcare Provider Details

I. General information

NPI: 1457044372
Provider Name (Legal Business Name): ENOCH YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16185 LOS GATOS BLVD STE 205
LOS GATOS CA
95032-4569
US

IV. Provider business mailing address

244 RAMONA AVE
PIEDMONT CA
94611-3934
US

V. Phone/Fax

Practice location:
  • Phone: 866-839-6979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number302280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: