Individual provider Active NPI

CHI Ly, PHARMD

  • Pharmacist
  • Elk Grove, CA
National Provider Identifier
1578971008
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57734 Issued in CA
Practice address
8465 Elk Grove Blvd
Elk Grove, CA 95758-9573
Phone
(916) 684-7104
Fax
(916) 684-7106
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57734 CA Primary

Addresses

Primary practice location

8465 Elk Grove Blvd
Elk Grove, CA 95758-9573

Mailing address

8465 Elk Grove Blvd
Elk Grove, CA 95758-9573
Phone (916) 684-7104

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
Doctor of Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1578971008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8465 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957589573",
            "telephone_number": "916-684-7104",
            "fax_number": "916-684-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8465 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957589573",
            "telephone_number": "916-684-7104",
            "fax_number": "916-684-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "CHI",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "57734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.