Provider Demographics
NPI:1629120852
Name:LI YEE GUO MD LTD
Entity Type:Organization
Organization Name:LI YEE GUO MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:YEE
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-360-6148
Mailing Address - Street 1:7918 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1990
Mailing Address - Country:US
Mailing Address - Phone:702-360-6148
Mailing Address - Fax:702-360-2879
Practice Address - Street 1:7918 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1990
Practice Address - Country:US
Practice Address - Phone:702-360-6148
Practice Address - Fax:702-360-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34450Medicare ID - Type Unspecified