Ly Phung Lam, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33646 Issued in CA

Practice address

308 N la Cadena Dr
Colton, CA 92324-2946

Phone

(909) 321-4700

NPI assigned

Nov 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ly.lam@scchc.eclinicaldirectplus.com

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group
• Cathy Nguyen, O.D., a Professional Optometric Corporation

  • Optometrist
  • Fontana, CA
  • NPI 1164205613
  Medicare reassignment NPD
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1639066491
  Medicare reassignment NPD
• Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ontario, CA
  • NPI 1710309513
  NPD
• Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Huntington Park, CA
  • NPI 1871484618
  NPD

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

{
    "created_epoch": "1351987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1144574732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623456",
            "telephone_number": "909-321-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N LA CADENA DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242946",
            "telephone_number": "909-321-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "LY",
        "middle_name": "PHUNG",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-04",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002712",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33646",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "308 N La Cadena Dr",
            "city": "Colton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923242946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasemine Monet Lakey, BCBA
• Lauren T Lakey
• Natalie Ann Lalone, ACSW
• Jasmine Jasmine Lam, MD
• Katherine Kim-Ngan Lam
• Laura Margarita Landaverde
• Lisa Landell
• Valerie Landeros
• Jeanne Marie Landers, BSHS, RAS
• Sebastian Lang

• Optometrist in Colton, CA
• Providers in Colton, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.