DR. UYEN T LY (NPI# 1700889128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700889128 |
| Entity Type | Individual |
| Full Name | DR. UYEN T LY |
| Credential | MD |
| Practice Address |
3802 Main Street Occidental CA 95465 |
| Mailing Address |
Po Box 1449 Guerneville CA 95446-1449 |
| Practice Telephone | 7078742444 |
| Practice Fax Number | 7078741664 |
| Mailing Telephone | 7078742444 |
| Mailing Fax Number | 7078741664 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A76278 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC03899G | 05 | |
| CA | BLUE SHIELD PIN | ZZZ23666Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851518773 | Uyen K Ly | Pathology | 1355 River Bend Dr, Dallas, TX 75247-4915 | 2007-04-20 |
| Street Address |
3802 MAIN STREET |
| City | OCCIDENTAL |
| State | CA |
| Zip Code | 95465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718413 | Kathleen O'brien | Social Worker | 3802 Main Street, Occidental, CA 95465 | 2005-05-31 |
| 1154659373 | Molly Rebecca Kirkconnell | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2009-11-28 |
| 1609878917 | Trina Bowen | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1427050731 | Victoria Davis | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1598768962 | West County Health Centers, Inc. | Clinic/Center | 3802 Main Street, Occidental, CA 95464 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831604669 | Theresa Sheppard Alexander | Marriage & Family Therapist | 3944 Harmony Village Circle, Occidental, CA 95465 | 2017-12-01 |
| 1053540591 | Dianna D, Evans | Marriage & Family Therapist | 5187 Occidental Camp Meeker Road, Occidental, CA 95465 | 2009-07-06 |
| 1902019524 | Miriam Redstone | Social Worker | 18200 Willow Creek Road, Occidental, CA 95465 | 2007-05-08 |
| 1629113717 | Shari Liggett Kovner | Nurse Practitioner | 3802 Main St., Occidental, CA 95465 | 2007-02-20 |
| 1720192487 | Wendy Wiley | Physician Assistant | 3802 Main St, Occidental, CA 95465 | 2006-08-19 |
| 1831107556 | Steven Louis Mcneal | Dentist | 4066 Bohemian Hwy, Occidental, CA 95465 | 2006-08-05 |
| 1033403563 | Andriy Shevchuk | Dentist | 4066 Bohemian Hwy, Occidental, CA 95465 | 2011-06-01 |
| 1043419559 | Rain Moore | Family Medicine | 3802 Main St, Occidental, CA 95465 | 2007-07-13 |
| 1922481431 | Jennifer Elizabeth Nagel | Acupuncturist | 3840 Doris Murphy Ct, Occidental, CA 95465-9130 | 2015-07-01 |
| 1922571611 | Cynthia Ann Kane Hyman | Registered Nurse | 2598 Joy Rd, Occidental, CA 95465-9262 | 2019-01-06 |
| Find all providers in zip 95465 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154659373 | Molly Rebecca Kirkconnell | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2009-11-28 |
| 1043419559 | Rain Moore | Family Medicine | 3802 Main St, Occidental, CA 95465 | 2007-07-13 |
| 1609878917 | Trina Bowen | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1427050731 | Victoria Davis | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407711 | Prohealth Partners A Medical Group | Family Medicine | 3700 Katella Ave Ste D, Los Alamitos, CA 90720-6410 | 2020-11-06 |
| 1831790112 | Universal Healthcare Services, Inc. | Family Medicine | 6025 Niles St, Bakersfield, CA 93306-4696 | 2020-11-04 |
| 1568063923 | Claude Kathy Marquis | Family Medicine | 400 S June St, Los Angeles, CA 90020-4812 | 2020-11-03 |
| 1417558842 | San Judas Tadeo Medical Group, Inc. | Family Medicine | 1000 S La Brea Ave Ste 2, Inglewood, CA 90301-3869 | 2020-11-03 |
| 1174123038 | Socal Medical Center., Inc. | Family Medicine | 1350 E Los Angeles Ave Ste 204, Simi Valley, CA 93065-2860 | 2020-10-29 |
| 1205435864 | Montana Affinity LLC | Family Medicine | 820 N Mountain Ave Ste 103, Upland, CA 91786-4163 | 2020-10-23 |
| 1861091126 | Silvia Diego Md Inc A Professional Medical Corp | Family Medicine | 1317 Oakdale Rd Ste 100, Modesto, CA 95355-3362 | 2020-10-19 |
| 1245838879 | Lalaine Talagtag Smith | Family Medicine | 919 Mariner Dr Apt C, Mountain View, CA 94043-3372 | 2020-10-15 |
| 1417554023 | Hameed A. Khan, M.d., Inc. | Family Medicine | 3655 Lomita Blvd Ste 421, Torrance, CA 90505-1934 | 2020-10-06 |
| 1073120085 | Garrison Family Medical Group Inc | Family Medicine | 41210 11th St W Ste C, Palmdale, CA 93551-1447 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
| City | OCCIDENTAL |
| Zip Code | 95465 |
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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.