Healthcare Provider Details

I. General information

NPI: 1730268269
Provider Name (Legal Business Name): MARCIA H YEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 3RD AVE
SAN DIEGO CA
92103-1407
US

IV. Provider business mailing address

PO BOX 232410
SAN DIEGO CA
92193-2410
US

V. Phone/Fax

Practice location:
  • Phone: 619-688-1600
  • Fax:
Mailing address:
  • Phone: 858-249-6748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberG52171
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: