Provider Demographics
NPI:1982626800
Name:YEE, TIM T (OD)
Entity Type:Individual
Prefix:DR
First Name:TIM
Middle Name:T
Last Name:YEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4029 POPPY PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-4512
Mailing Address - Country:US
Mailing Address - Phone:619-281-5909
Mailing Address - Fax:
Practice Address - Street 1:8940 RESEDA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3900
Practice Address - Country:US
Practice Address - Phone:818-993-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 12876T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist