Individual provider Active NPI

Lilly Ha

  • Physician Assistant
  • Laguna Beach, CA
National Provider Identifier
1275339244
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
310 Glenneyre St
Laguna Beach, CA 92651-2311
Phone
(949) 209-9266
Fax
(949) 209-9267
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

310 Glenneyre St
Laguna Beach, CA 92651-2311

Mailing address

310 Glenneyre St
Laguna Beach, CA 92651-2311
Phone (949) 209-9266

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251112000900 CA Practitioner - Physician Assistant 0244721876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10438 Morning Glory Ave
Fountain Valley, CA 92708-1137

310 Glenneyre St
Laguna Beach, CA 92651-2311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
67141CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dolcemd a California Professional Medical Corporation CurrentSince Oct 7, 2025 Accepting new patients

Locations

310 Glenneyre St
Laguna Beach, CA 92651
Phone (949) 209-9266

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.

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1275339244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 GLENNEYRE ST",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512311",
            "telephone_number": "949-209-9266",
            "fax_number": "949-209-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 GLENNEYRE ST",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512311",
            "telephone_number": "949-209-9266",
            "fax_number": "949-209-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "LILLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

Verify at the official NPI Registry.