Healthcare Provider Details

I. General information

NPI: 1114029287
Provider Name (Legal Business Name): YEE ADVANCED ORTHOPEDICS AND SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7195 ADVANCED WAY
LAS VEGAS NV
89113-3624
US

IV. Provider business mailing address

PO BOX 50605
HENDERSON NV
89016-0605
US

V. Phone/Fax

Practice location:
  • Phone: 702-740-5327
  • Fax: 702-740-5328
Mailing address:
  • Phone: 702-740-5327
  • Fax: 702-740-5328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number13004
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number1160
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number12394
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0606
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA1006
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA1140
License Number StateNV
# 7
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number1052
License Number StateNV

VIII. Authorized Official

Name: RANDALL E YEE
Title or Position: OWNER
Credential: DO
Phone: 702-740-5327