Provider Demographics
NPI:1477609980
Name:YEE, MARIE SOUZON (OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:SOUZON
Last Name:YEE
Suffix:
Gender:F
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28004 RIDGEFOREST CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3267
Mailing Address - Country:US
Mailing Address - Phone:310-265-0261
Mailing Address - Fax:
Practice Address - Street 1:4301 ATLANTIC AVE STE 6
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2833
Practice Address - Country:US
Practice Address - Phone:562-427-8971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7695171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist