1275725418 NPI number — DR. JENNIFER KUANG WEI YEE MD

Table of content: DR. JENNIFER KUANG WEI YEE MD (NPI 1275725418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275725418 NPI number — DR. JENNIFER KUANG WEI YEE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YEE
Provider First Name:
JENNIFER
Provider Middle Name:
KUANG WEI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ENG
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
KUANG WEI YEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1275725418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 W CARSON ST
Provider Second Line Business Mailing Address:
HARBOR BOX 446
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90502-2004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-222-1971
Provider Business Mailing Address Fax Number:
310-222-3887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 W CARSON ST
Provider Second Line Business Practice Location Address:
HARBOR BOX 446
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90502-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-222-1971
Provider Business Practice Location Address Fax Number:
310-222-3887
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0205X , with the licence number:  A80403 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A804030 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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