Healthcare Provider Details

I. General information

NPI: 1588157853
Provider Name (Legal Business Name): YUELING LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11878 AVENUE OF INDUSTRY
SAN DIEGO CA
92128-3423
US

IV. Provider business mailing address

PO BOX 1770
LA MESA CA
91944-1770
US

V. Phone/Fax

Practice location:
  • Phone: 760-566-6633
  • Fax: 814-228-2117
Mailing address:
  • Phone: 619-464-1165
  • Fax: 619-567-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA173698
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA173698
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD477148
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: