LY THANH DUONG (NPI# 1497261614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497261614 |
| Entity Type | Individual |
| Full Name | LY THANH DUONG |
| Credential | NP |
| Practice Address |
3660 Park Sierra Dr Riverside CA 92505-3081 |
| Mailing Address |
855 E Hospitality Ln San Bernardino CA 92408-3596 |
| Practice Telephone | 9516372100 |
| Mailing Telephone | 9098850282 |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95007415 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
95007415 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3660 PARK SIERRA DR |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92505-3081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457300436 | Mission Surgical Clinic, Inc. | Physician Assistant | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3071 | 2006-05-08 |
| 1730734450 | Teresa Pham | Behavior Technician | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2019-08-08 |
| 1104276393 | Mission Surgical Group | Clinic/Center | 3660 Park Sierra Dr, Riverside, CA 92505-3081 | 2016-06-17 |
| 1326443201 | Neighborhood Health Systems | Non-Pharmacy Dispensing Site | 3660 Park Sierra Dr, Suite 110, Riverside, CA 92505-3081 | 2014-11-04 |
| 1366857039 | Neighborhood Health Systems | Clinic/Center | 3660 Park Sierra Dr, Suite 110, Riverside, CA 92505-3081 | 2014-06-21 |
| 1881991040 | First Call Medical Group | Specialist | 3660 Park Sierra Dr, 101, Riverside, CA 92505-3081 | 2011-02-23 |
| 1053544569 | Doris Sophia Li | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2009-08-31 |
| 1710137401 | Eric Changchien | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2008-09-30 |
| 1073761243 | Rizwan Badar | Internal Medicine | 3660 Park Sierra Dr, Suite 208, Riverside, CA 92505-3081 | 2008-08-29 |
| 1700047875 | Tina T Ng | Surgery | 3660 Park Sierra Dr, Suite 105, Riverside, CA 92505-3081 | 2008-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205458460 | Mark Anthony Vargas | Behavioral Analyst | 94193 Flat Rock Dr Ste 220, Riverside, CA 92505 | 2020-05-11 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1588222087 | A Homecare Services, Inc | In Home Supportive Care | 4193 Flat Rock Road, Building 200 Suite 206, Riverside, CA 92505 | 2019-05-31 |
| 1609302397 | Tap Pharmacy, Inc. | Pharmacy | 4270 Riverwalk Pkwy Ste 102, Riverside, CA 92505 | 2017-05-02 |
| 1467998658 | Onofre Gascon | Behavior Technician | 11711 Collett Ave, #1614, Riverside, CA 92505 | 2017-01-11 |
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1447639901 | Jose Joel Manalese Dds Inc | Dentist | 3950 Pierce St., Suite L., Riverside, CA 92505 | 2015-05-29 |
| 1821493230 | Jean Huynh | Physician Assistant | 11725 State Ave., Suite 100, Riverside, CA 92505 | 2014-10-28 |
| 1003160649 | Elaf Farahat | Dietitian, Registered | 10800 Magnolia Avenue., Riverside, CA 92505 | 2012-11-05 |
| 1730458217 | Tammy Lynn Gilmore | Non-emergency Medical Transport (VAN) | 10770 Hole Avenue, 106, Riverside, CA 92505 | 2011-12-29 |
| Find all providers in zip 92505 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801425145 | Alpha Shanika Gonzalez | Nurse Practitioner | 5750 Division St Ste 204, Riverside, CA 92506-3260 | 2020-04-08 |
| 1184264517 | Michael Josiah | Nurse Practitioner | 16254 Bridgton Cir, Riverside, CA 92503-5978 | 2020-01-14 |
| 1346885738 | Rose Jionna Newton | Nurse Practitioner | 750 Via Pueblo Apt 201, Riverside, CA 92507-6376 | 2019-11-09 |
| 1952957375 | April Blum | Nurse Practitioner | 14200 Meridian Parkway, # 101, Riverside, CA 92518 | 2019-08-12 |
| 1487209326 | Glecy Kristine Tan Lua | Nurse Practitioner | 7992 Wood Rd, Riverside, CA 92508-6605 | 2019-08-07 |
| 1386119725 | Eugene Santos | Nurse Practitioner | 3600 Lime St Ste 516, Riverside, CA 92501-0944 | 2018-10-12 |
| 1407356918 | Reyna Acela Reynaga-vargas | Nurse Practitioner | 5430 Arlington Ave # Na, Riverside, CA 92504-2505 | 2018-02-20 |
| 1174021646 | Mary Anne Brown | Nurse Practitioner | 10895 Magnolia Ave, Riverside, CA 92505-3057 | 2018-01-30 |
| 1295249167 | Emily Fernandez | Nurse Practitioner | 9444 Alta Cresta Ave, Riverside, CA 92508-8032 | 2017-11-29 |
| 1124538152 | Clara Nnadi | Nurse Practitioner | 18445 Pinecone Ln, Riverside, CA 92504-9420 | 2017-10-04 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.