Michael Minh Ba Ly, D.O

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

11700T Issued in CA

Practice address

22450 Town Cir
Moreno Valley, CA 92553-7506

Phone

(951) 653-1055

NPI assigned

Sep 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arthur Friedman OD a Professional Optometric Corporation

  • Optometrist
  • San Bernardino, CA
  • NPI 1679628069
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1013014794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4868 GOLDEN RIDGE DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928809421",
            "telephone_number": "951-898-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22450 TOWN CIR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537506",
            "telephone_number": "951-653-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "MICHAEL",
        "middle_name": "MINH BA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11700T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "11700T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "CA1700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cailey Lushanko, DNP-CRNA
• Vanson Tradzu Luu, PHARMD
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Jeannie Ly
• Lynn Daz, D.D.S. ,Inc.
• M & M Medical
• M Cecilia Gonzalez DDS a Prof Corp
• M&H Wellness and Professional Nursing, Inc.
• M&J Medical Transportation Corp

• Pediatric Optometrist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Pediatric Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.