MEDICARE: LARRY 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	332900000X	Non-Pharmacy Dispensing Site	4655	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2982139	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1457434789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY YEE MD

Provider Business Mailing Address
First Line	:	7660 W CHEYENNE AVE STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6757
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7660 W CHEYENNE AVE STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6757
Country	:	US
Telephone Number	:	702-240-5456
Fax Number	:	702-240-1692

Authorized Official
Title or Position	:	MANAGED CARE SPECIALIST
Name	:	DIRENDIA SHACKELFORD
Credential	:
Telephone Number	:	800-654-0889

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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Directions to “LARRY YEE MD ” Practice Location

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