Healthcare Provider Details

I. General information

NPI: 1932381126
Provider Name (Legal Business Name): CARY KA-HUM YEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CENTRAL AVE STE 187
RIVERSIDE CA
92507-6516
US

IV. Provider business mailing address

600 CENTRAL AVE STE 187
RIVERSIDE CA
92507-6516
US

V. Phone/Fax

Practice location:
  • Phone: 951-536-5123
  • Fax: 951-742-5214
Mailing address:
  • Phone: 951-536-5123
  • Fax: 951-741-5214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA 39133
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA39133
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA39133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: