Provider Demographics
NPI:1851767362
Name:MARKHAM, YOUNG KEE (NP)
Entity Type:Individual
Prefix:
First Name:YOUNG KEE
Middle Name:
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TIVERTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8919
Mailing Address - Country:US
Mailing Address - Phone:310-825-2220
Mailing Address - Fax:
Practice Address - Street 1:700 TIVERTON AVENUE
Practice Address - Street 2:
Practice Address - City:L.A.
Practice Address - State:CA
Practice Address - Zip Code:90095-8919
Practice Address - Country:US
Practice Address - Phone:310-825-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5268363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner