Provider Demographics
NPI:1790878551
Name:YEE, GENNIE (MD)
Entity type:Individual
Prefix:
First Name:GENNIE
Middle Name:
Last Name:YEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 OLD NEWPORT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4252
Mailing Address - Country:US
Mailing Address - Phone:949-548-9611
Mailing Address - Fax:949-548-9958
Practice Address - Street 1:415 OLD NEWPORT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4252
Practice Address - Country:US
Practice Address - Phone:949-548-9611
Practice Address - Fax:949-548-9958
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA96040207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine