Healthcare Provider Details

I. General information

NPI: 1255670824
Provider Name (Legal Business Name): MEL AARON T YEE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2013
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1173 FRONT ST
SAN DIEGO CA
92101-3904
US

IV. Provider business mailing address

1852 CAMINO MOJAVE
CHULA VISTA CA
91914-4615
US

V. Phone/Fax

Practice location:
  • Phone: 619-615-2700
  • Fax:
Mailing address:
  • Phone: 619-781-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number825381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: