Provider Demographics
NPI:1275995490
Name:LI, CATHLEEN YI (DO)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:YI
Last Name:LI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11618 SOUTH ST STE 214
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-6618
Mailing Address - Country:US
Mailing Address - Phone:626-215-3111
Mailing Address - Fax:
Practice Address - Street 1:15725 WHITTIER BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2338
Practice Address - Country:US
Practice Address - Phone:562-947-1669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine