Cuong Ly MD, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A73873 Issued in CA

Legal business name

CUONG LY MD, INC

Practice address

23321 El Toro Rd
Suite H
Lake Forest, CA 92630-4825

Phone

(949) 305-2660

Fax

(949) 305-2036

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Cuong Phu Ly II, MD

Title

Chief Executive Officer

Phone

(714) 425-9403

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1164694014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23321 EL TORO RD",
            "address_2": "SUITE H",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304825",
            "telephone_number": "949-305-2660",
            "fax_number": "949-305-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23321 EL TORO RD",
            "address_2": "SUITE H",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304825",
            "telephone_number": "949-305-2660",
            "fax_number": "949-305-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUONG LY MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "CUONG",
        "authorized_official_middle_name": "PHU",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-425-9403",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A73873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.