Healthcare Provider Details

I. General information

NPI: 1609866748
Provider Name (Legal Business Name): BEVERLY M YEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 W WARM SPRINGS RD
LAS VEGAS NV
89113-3612
US

IV. Provider business mailing address

PO BOX 50864
HENDERSON NV
89016-0864
US

V. Phone/Fax

Practice location:
  • Phone: 702-458-5099
  • Fax: 702-458-5199
Mailing address:
  • Phone: 702-458-5099
  • Fax: 702-458-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10658
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: