Provider Demographics
NPI:1710938675
Name:YEE, MICHAEL YICK TIM (MD,)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:YICK TIM
Last Name:YEE
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:# 211
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-261-0765
Mailing Address - Fax:808-262-5636
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:# 211
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4400
Practice Address - Country:US
Practice Address - Phone:808-261-0765
Practice Address - Fax:808-262-5636
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5733207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA06239-6OtherHMSA
HIA06239-6Medicaid
HIA06239-6OtherHMSA
D51905Medicare UPIN