Healthcare Provider Details

I. General information

NPI: 1598515033
Provider Name (Legal Business Name): MATTHEW YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 NAPIER AVE
SAINT JOSEPH MI
49085-2112
US

IV. Provider business mailing address

2936 CLOVER CT
FULLERTON CA
92835-4309
US

V. Phone/Fax

Practice location:
  • Phone: 269-982-4941
  • Fax:
Mailing address:
  • Phone: 714-882-9823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: