Healthcare Provider Details

I. General information

NPI: 1174012587
Provider Name (Legal Business Name): C EDWARD YEE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 W HORIZON RIDGE PKWY
HENDERSON NV
89052
US

IV. Provider business mailing address

2980 S JONES BLVD SUITE A
LAS VEGAS NV
89146-5657
US

V. Phone/Fax

Practice location:
  • Phone: 702-362-3937
  • Fax: 702-362-7935
Mailing address:
  • Phone: 702-362-3937
  • Fax: 702-362-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberNV7830
License Number StateNV

VIII. Authorized Official

Name: TANYA HUFFMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-362-3937