MEDICARE: LI YEE GUO MD LTD

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	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1629120852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LI YEE GUO MD LTD

Provider Business Mailing Address
First Line	:	7918 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-360-6148
Fax Number	:	702-360-2879

Provider Business Practice Location Address
First Line	:	7918 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-360-6148
Fax Number	:	702-360-2879

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LI YEE GUO
Credential	:	M.D.
Telephone Number	:	702-360-6148

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/08/2007

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