Red Hill Spine, K. Ly Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC30062 Issued in CA

Legal business name

RED HILL SPINE, K. LY CHIROPRACTIC CORPORATION

Practice address

10722 Arrow Rte Ste 102
Rancho Cucamonga, CA 91730-4809

Phone

(909) 466-5101

NPI assigned

Jun 26, 2018

Last updated

May 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kheang Ly, DCNPI 1154340206

Title

President

Phone

(909) 989-0944

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kheang Ly, D.C.

  • Chiropractor
  • Rancho Cucamonga, CA
  • NPI 1154340206
  NPD Authorized official

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1396230041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304809",
            "telephone_number": "909-466-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304809",
            "telephone_number": "909-466-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED HILL SPINE, K. LY CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "KHEANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-989-0944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DC30062",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.