Xuan Grace L. Ly, PHARM.D.

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

53871 Issued in CA

Practice address

11201 Benton St
Loma Linda, CA 92357-3927

Phone

(909) 825-7084

NPI assigned

Sep 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1952550337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PACIFIC COAST HWY",
            "address_2": "UNIT #205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484480",
            "telephone_number": "951-522-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923573927",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26520 Cactus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925553927",
            "country_code": "US",
            "telephone_number": "951-486-4529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "XUAN GRACE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "53871",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "53871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri Thanh Luu, M.D
• Ann Ly, MSGC
• Dominie Trang Ly
• Megan Danthu Ly, PHARMD
• Tamara Ly, PHARMD
• David Allen Lynn, RRT
• Emma Keiko Lynne, CRNA
• Spencer Lyons
• Andrew Ma, MSW
• Elizabeth Ma, MD, PHD

• Pharmacotherapy Pharmacist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pharmacotherapy Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.