Healthcare Provider Details
I. General information
NPI: 1023130713
Provider Name (Legal Business Name): LAWRENCE ZALE YEE M.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15047 LOS GATOS BLVD SUITE 180
LOS GATOS CA
95032-2054
US
IV. Provider business mailing address
2166 CRUDEN BAY WAY
GILROY CA
95020-3082
US
V. Phone/Fax
- Phone: 408-358-6505
- Fax: 408-358-6404
- Phone: 408-846-0118
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | CA32061 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: