Provider Demographics
NPI:1518288687
Name:LEE, YI-CHIEN EMMA (DO)
Entity Type:Individual
Prefix:DR
First Name:YI-CHIEN
Middle Name:EMMA
Last Name:LEE
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 1:12512 CELEBRATION DR
Mailing Address - Street 2:
Mailing Address - City:MIRA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91752-7603
Mailing Address - Country:US
Mailing Address - Phone:805-698-8917
Mailing Address - Fax:
Practice Address - Street 1:5827 PINE AVE STE A
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6534
Practice Address - Country:US
Practice Address - Phone:909-613-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11038207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine