Healthcare Provider Details

I. General information

NPI: 1699296392
Provider Name (Legal Business Name): YEE LIONG LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 S CURRY ST
CARSON CITY NV
89703-5100
US

IV. Provider business mailing address

1460 S CURRY ST
CARSON CITY NV
89703-5100
US

V. Phone/Fax

Practice location:
  • Phone: 774-445-5181
  • Fax:
Mailing address:
  • Phone: 775-461-3083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number30988
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125070025
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number22210
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: