Provider Demographics
NPI:1609151927
Name:JOHN K YEE MD INCORPORATE
Entity Type:Organization
Organization Name:JOHN K YEE MD INCORPORATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-772-2390
Mailing Address - Street 1:1120 W LA PALMA AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2801
Mailing Address - Country:US
Mailing Address - Phone:714-772-2390
Mailing Address - Fax:
Practice Address - Street 1:1120 W LA PALMA AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2801
Practice Address - Country:US
Practice Address - Phone:714-772-2390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34852207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2211318Medicaid
CA2211318Medicaid