Active NPI
Kathy Nhi Ly
- Physician Assistant
- Carson, CA
National Provider Identifier
1043080740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 64699
- Practice address
- 522 W Carson St
Carson, CA 90745-2635 - Phone
- (310) 320-3400
- NPI assigned
- Jan 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 64699 | CA | Primary |
Addresses
Primary practice location
522 W Carson St
Carson, CA 90745-2635
Mailing address
9071 Imperial Ave
Garden Grove, CA 92844-1301
Phone (714) 867-3032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64699 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Urgent Care and Wellness Center, Inc. | Current | Accepting new patients |
Locations
522 W Carson St
Carson, CA 90745
Phone (310) 320-3400
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Carson, CA
- NPI 1275948994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1043080740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9071 IMPERIAL AVE",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928441301",
"telephone_number": "714-867-3032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 W CARSON ST",
"city": "CARSON",
"state": "CA",
"postal_code": "907452635",
"telephone_number": "310-320-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "KATHY",
"middle_name": "NHI",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-03",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "64699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.