Provider Demographics
NPI:1659407476
Name:YIU FUN DEREK LEE MD INC
Entity Type:Organization
Organization Name:YIU FUN DEREK LEE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-369-1886
Mailing Address - Street 1:16388 COLIMA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5525
Mailing Address - Country:US
Mailing Address - Phone:626-369-1886
Mailing Address - Fax:626-369-2557
Practice Address - Street 1:16388 COLIMA RD STE 203
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5525
Practice Address - Country:US
Practice Address - Phone:626-369-1886
Practice Address - Fax:626-369-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81110207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG81110OtherLICENCE