Healthcare Provider Details

I. General information

NPI: 1417157736
Provider Name (Legal Business Name): CLIFFORD YEE PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR
ORANGE CA
92868-3854
US

IV. Provider business mailing address

62 GLEN ARBOR
IRVINE CA
92602-1668
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8222
  • Fax:
Mailing address:
  • Phone: 714-336-7736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 25709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: