Tiffany Tong Ly

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA67669 Issued in CA

Practice address

4060 Fairmount Ave
San Diego, CA 92105-1608

Phone

(714) 400-5093

NPI assigned

Apr 26, 2024

Last updated

Feb 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• La Maestra Family Clinic, Inc.

  dba La Maestra Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1306929443
  Medicare reassignment
• La Maestra Family Clinic, Inc.

  dba La Maestra Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1568209773
  NPD

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1225884554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6234 OSLER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115408",
            "telephone_number": "714-400-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "714-400-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "TIFFANY",
        "middle_name": "TONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ly, LMFT
• Minh-Nguyet Michelle Ly
• San Hue Ly
• Shai T. Ly, D.P.T.
• Sopheap Ly, MD
• Kristen Elaine Lyall, AMFT
• Caterina Alyssa Lybarger
• Pamela Lybarger
• Steven Edward Lybarger, RN
• Wil Kirk Lybarger, RAS, NCAC1

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.