MEDICARE: DR. GORDON GAR KWONG YEE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD00032538	WA
2	207X00000X	Orthopaedic Surgery Physician	C54969	CA
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	MD00032538	WA
4	207XS0117X	Orthopaedic Surgery of the Spine Physician	C54969	CA

General Provider Information

NPI Number	:	1013089663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GORDON GAR KWONG YEE MD

Provider Business Mailing Address
First Line	:	341 MAGNOLIA AVE STE 101
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-3331
Country	:	US
Telephone Number	:	951-256-8820
Fax Number	:	951-257-7510

Provider Business Practice Location Address
First Line	:	341 MAGNOLIA AVE STE 101
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-3331
Country	:	US
Telephone Number	:	951-256-8820
Fax Number	:	951-257-7510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/15/2023

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