Healthcare Provider Details

I. General information

NPI: 1205035144
Provider Name (Legal Business Name): KIN KEUNG YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARK CENTER DR STE 210
SACRAMENTO CA
95825-8341
US

IV. Provider business mailing address

7101 FAIRWAY DR
PALM BEACH GARDENS FL
33418-3701
US

V. Phone/Fax

Practice location:
  • Phone: 916-454-6191
  • Fax:
Mailing address:
  • Phone: 561-515-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number002349
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number257190
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME115962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: