Ly, Peter Phong
Ly, Peter Phong is an sole proprietor health care provider with primary practice located at 10921 Cherry St Ste 200 , Los Alamitos CA 90720-2473. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Ly, Peter Phong can be contacted via phone (562) 407-2080.Contact Information
Primary practice address
10921 Cherry St Ste 200
Los Alamitos CA 90720-2473
Phone: (562) 407-2080
Fax: (562) 407-2082
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | A65780 | California |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | A65780 | California |
Profile Details
| NPI number | 1588684724 |
|---|---|
| LBN Legal business name | Ly, Peter Phong |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Sep 30th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588684724 | NPPES |
| California | MEDICAID | 00A657800 |
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