Individual provider Active NPI

Thuc N Ly, PA-C

  • Physician Assistant
  • West Covina, CA
National Provider Identifier
1407968712
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16370 Issued in CA
Practice address
3433 Fionna PL
West Covina, CA 91792-5703
Phone
(626) 675-8169
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 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 PA16370 CA Primary

Addresses

Primary practice location

3433 Fionna PL
West Covina, CA 91792-5703

Mailing address

3433 Fionna PL
West Covina, CA 91792-5703
Phone (626) 675-8169

Other identifiers 1

IdentifierTypeStateIssuer
952662606OtherCAGRP TAX ID #

Other names 1

  • David Ly Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20050920000982 CA Practitioner - Physician Assistant 1759315724 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526

215 N Allen Ave
Pasadena, CA 91106-1601
Phone (626) 817-9002

2671 Blanding Ave
Suite a
Alameda, CA 94501-1587
Phone (510) 694-4816

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

420 W Rowland St
Suite 101
Covina, CA 91723-2943
Phone (626) 412-2614

600 S Lake Ave
Suite 105
Pasadena, CA 91106-3955
Phone (626) 844-8848

8985 Venice Blvd
Suite a 3B
Los Angeles, CA 90034-3344
Phone (424) 502-1020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Dec 20, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 17, 2025 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 17, 2025 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

7330 El Camino Real
Atascadero, CA 93422
Phone (805) 703-2501

6971 El Camino Real
Ste 101
Carlsbad, CA 92009
Phone (760) 258-4971

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

11971 Central Ave
Ste B
Chino, CA 91710
Phone (909) 310-1488

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

420 W Rowland St
Covina, CA 91723
Phone (626) 331-6411

14117 Limonite Ave
Ste 300
Eastvale, CA 92880
Phone (951) 210-7237

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

806 New Los Angeles Ave
Moorpark, CA 93021
Phone (805) 334-8650

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Interoperability endpoints

  • Direct secure messaging: thuc.ly.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 10

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1407968712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 FIONNA PL",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917925703",
            "telephone_number": "626-675-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 FIONNA PL",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917925703",
            "telephone_number": "626-675-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "THUC",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP TAX ID #",
            "identifier": "952662606",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "LY",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.