Healthcare Provider Details

I. General information

NPI: 1669826129
Provider Name (Legal Business Name): YUEL-KAI JEAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date: 12/06/2016
Reactivation Date: 12/22/2016

III. Provider practice location address

1500 HIGHLANDS DR
LITITZ PA
17543-7694
US

IV. Provider business mailing address

1500 HIGHLANDS DR
LITITZ PA
17543-7694
US

V. Phone/Fax

Practice location:
  • Phone: 717-782-5118
  • Fax: 717-782-5854
Mailing address:
  • Phone: 717-782-5118
  • Fax: 717-782-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberOS023161
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: