Peter Ly MD Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A65780 Issued in CA

Legal business name

PETER LY MD MEDICAL CORPORATION

Practice address

10921 Cherry St Ste 200
Los Alamitos, CA 90720-2473

Phone

(562) 407-2080

Fax

(562) 407-2082

NPI assigned

Mar 5, 2008

Organization subpart

No

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

Authorized official

Name

Peter Ly, MDNPI 1588684724

Title

President

Phone

(562) 407-2080

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Phong Ly, M.D.

  • Anesthesiology Physician
  • Los Alamitos, CA
  • NPI 1588684724
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1508036591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4259",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907034259",
            "telephone_number": "562-407-2080",
            "fax_number": "562-407-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 CHERRY ST STE 200",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202473",
            "telephone_number": "562-407-2080",
            "fax_number": "562-407-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER LY MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-407-2080",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A65780",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A65780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael W. Perlman, M.D.
• Perry R Secor MD Medical Corporation
• Caroline Cook Persek, MA
• Kaitlyn Lee Pershall
• Amy Pesceone-Brborich, MFT
• Claire Peters
• Christi Ann Peterson, D.M.D.
• Petrichor Healing Family Therapy, Inc.
• Andrew Pham, DDS
• Kaylyn Bich Hong Pham, PHARMD

• Anesthesiology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.