Active NPI
Phung Kim Ly
- Pharmacist
- Arcadia, CA
National Provider Identifier
1780101469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74397
- Practice address
- 612 W Duarte Rd Ste 102
Arcadia, CA 91007-9221 - Phone
- (626) 317-5001
- NPI assigned
- Aug 24, 2017
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74397 | CA | Primary |
Addresses
Primary practice location
612 W Duarte Rd Ste 102
Arcadia, CA 91007-9221
Mailing address
88 S Marengo Ave Unit C
Alhambra, CA 91801-1950
Phone (571) 232-9363
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74397 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KM Healthcare Inc | Past | Accepting new patients | |
| Alpha M Edical Pharmacy | Past | Accepting new patients | |
| CTM Pharmacy Corp | Pharmacist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Alhambra, CA
- NPI 1821409814
-
- Community/Retail Pharmacy
- Arcadia, CA
- NPI 1144064510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773187200000",
"number": "1780101469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 S MARENGO AVE UNIT C",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918011950",
"telephone_number": "571-232-9363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 W DUARTE RD STE 102",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910079221",
"telephone_number": "626-317-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "PHUNG",
"middle_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2026-03-11",
"certification_date": "2026-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "74397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.