MEDICARE: YEE ADVANCED ORTHOPEDICS AND SPORTS MEDICINE PC

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	13004	NV
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	1160	NV
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	12394	NV
4	213ES0103X	Foot & Ankle Surgery Podiatrist	0606	NV
5	363AS0400X	Surgical Physician Assistant	PA1006	NV
6	363AS0400X	Surgical Physician Assistant	PA1140	NV
7	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	1052	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114029287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEE ADVANCED ORTHOPEDICS AND SPORTS MEDICINE PC

Provider Business Mailing Address
First Line	:	PO BOX 50605
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89016-0605
Country	:	US
Telephone Number	:	702-740-5327
Fax Number	:	702-740-5328

Provider Business Practice Location Address
First Line	:	7195 ADVANCED WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3624
Country	:	US
Telephone Number	:	702-740-5327
Fax Number	:	702-740-5328

Authorized Official
Title or Position	:	OWNER
Name	:	RANDALL E YEE
Credential	:	DO
Telephone Number	:	702-740-5327

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	02/13/2019

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Directions to “YEE ADVANCED ORTHOPEDICS AND SPORTS MEDICINE PC ” Practice Location

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