MEDICARE: GENNIE 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	207R00000X	Internal Medicine Physician	A96040	CA
2	207RC0000X	Cardiovascular Disease Physician	A96040	CA

General Provider Information

NPI Number	:	1790878551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENNIE YEE MD

Provider Business Mailing Address
First Line	:	415 OLD NEWPORT BLVD STE 200
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4252
Country	:	US
Telephone Number	:	949-548-9611
Fax Number	:	949-548-9958

Provider Business Practice Location Address
First Line	:	415 OLD NEWPORT BLVD STE 200
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4252
Country	:	US
Telephone Number	:	949-548-9611
Fax Number	:	949-548-9958

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/02/2025

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Directions to “ GENNIE YEE MD” Practice Location

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