Provider Demographics
NPI:1467401471
Name:YEE, LARRY (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:YEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7660 W CHEYENNE AVE
Mailing Address - Street 2:# 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6760
Mailing Address - Country:US
Mailing Address - Phone:702-240-5456
Mailing Address - Fax:702-240-1692
Practice Address - Street 1:7660 W CHEYENNE AVE
Practice Address - Street 2:# 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6760
Practice Address - Country:US
Practice Address - Phone:702-240-5456
Practice Address - Fax:702-240-1692
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019589Medicaid
NVV31561Medicare PIN
NV002019589Medicaid