Provider Demographics
NPI:1376018846
Name:YEE, OLAVE S (OD)
Entity Type:Individual
Prefix:
First Name:OLAVE
Middle Name:S
Last Name:YEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15920 POMONA RINCON RD UNIT 6210
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-5529
Mailing Address - Country:US
Mailing Address - Phone:949-784-9184
Mailing Address - Fax:
Practice Address - Street 1:3951 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5429
Practice Address - Country:US
Practice Address - Phone:909-548-5355
Practice Address - Fax:909-614-8083
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34131TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist