Basic Information
Provider Information
NPI: 1497743116
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YEE
FirstName: ROBERT
MiddleName: SHIH
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 61250 SE COOMBS PL
Address2:  
City: BEND
State: OR
PostalCode: 977023704
CountryCode: US
TelephoneNumber: 5417063593
FaxNumber:  
Practice Location
Address1: 61250 SE COOMBS PL
Address2:  
City: BEND
State: OR
PostalCode: 977023704
CountryCode: US
TelephoneNumber: 5417065935
FaxNumber: 5417065936
Other Information
ProviderEnumerationDate: 10/06/2005
LastUpdateDate: 06/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X27015AZY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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