Active NPI
Julie Mysinh Ly, PA-C
- Physician Assistant
- Fullerton, CA
National Provider Identifier
1497909113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA20056
- Practice address
- 501 S Brookhurst Rd
Fullerton, CA 92833-3207 - Phone
- (714) 870-0717
- NPI assigned
- Nov 7, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA20056 | CA | Primary |
Addresses
Primary practice location
501 S Brookhurst Rd
Fullerton, CA 92833-3207
Mailing address
501 S Brookhurst Rd
Fullerton, CA 92833-3207
Other practice location 1
1421 E 17th St
Santa Ana, CA 92705-8505
Phone (714) 922-4100
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA20056 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood/Orange and San Bernardino Counties, Inc. | Past | Accepting new patients | |
| Emergency Medicine Physician Partners of Riverside County, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Moreno Valley, CA
- NPI 1750682712
-
- Clinic/Center
- Anaheim, CA
- NPI 1710975727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1497909113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S BROOKHURST RD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928333207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S BROOKHURST RD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928333207",
"telephone_number": "714-870-0717"
}
],
"practiceLocations": [
{
"address_1": "1421 E 17th St",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927058505",
"country_code": "US",
"telephone_number": "714-922-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LY",
"first_name": "JULIE",
"middle_name": "MYSINH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-07",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA20056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.