Provider Demographics
NPI:1780722264
Name:YEE, MASTON JOHN
Entity type:Individual
Prefix:MR
First Name:MASTON
Middle Name:JOHN
Last Name:YEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34393 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1539
Mailing Address - Country:US
Mailing Address - Phone:734-522-6500
Mailing Address - Fax:734-522-6510
Practice Address - Street 1:34393 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1539
Practice Address - Country:US
Practice Address - Phone:734-522-6500
Practice Address - Fax:734-522-6510
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician