Healthcare Provider Details

I. General information

NPI: 1306270004
Provider Name (Legal Business Name): YUMI ELIZABETH SIU LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N 12TH ST
GRAND JUNCTION CO
81501-2914
US

IV. Provider business mailing address

PO BOX 1727
GRAND JCT CO
81502-1727
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-9340
  • Fax: 970-241-6894
Mailing address:
  • Phone: 970-263-2619
  • Fax: 970-263-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberTL0006092
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDR.0061203
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: