Healthcare Provider Details

I. General information

NPI: 1689727919
Provider Name (Legal Business Name): ANITA YIN YEE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA YIN YEE-IWAMI

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 THE SHOPS AT MISSION VIEJO
MISSION VIEJO CA
92691-6527
US

IV. Provider business mailing address

1131 SANTOLINA DR
NOVATO CA
94945-1854
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-4010
  • Fax: 949-364-4001
Mailing address:
  • Phone: 415-892-9426
  • Fax: 415-466-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11785T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: