Healthcare Provider Details

I. General information

NPI: 1467401471
Provider Name (Legal Business Name): LARRY YEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7660 W CHEYENNE AVE # 110
LAS VEGAS NV
89129-6760
US

IV. Provider business mailing address

7660 W CHEYENNE AVE # 110
LAS VEGAS NV
89129-6760
US

V. Phone/Fax

Practice location:
  • Phone: 702-240-5456
  • Fax: 702-240-1692
Mailing address:
  • Phone: 702-240-5456
  • Fax: 702-240-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4655
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: