Healthcare Provider Details

I. General information

NPI: 1770073017
Provider Name (Legal Business Name): JULIA YI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3992
US

IV. Provider business mailing address

861 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3992
US

V. Phone/Fax

Practice location:
  • Phone: 702-896-0940
  • Fax: 702-896-6173
Mailing address:
  • Phone: 702-896-0940
  • Fax: 702-896-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number27277
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: