Individual provider Active NPI

Thanh Ly, RPH

  • Pharmacist
  • Eastvale, CA
National Provider Identifier
1437624939
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
74086 Issued in CA
Practice address
12471 Limonite Ave
Eastvale, CA 91752-2457
Phone
(951) 256-5262
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 74086 CA Primary

Addresses

Primary practice location

12471 Limonite Ave
Eastvale, CA 91752-2457

Mailing address

12471 Limonite Ave
Eastvale, CA 91752-2457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
74086CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1437624939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12471 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "917522457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12471 LIMONITE AVE",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "917522457",
            "telephone_number": "951-256-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "THANH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.