Individual provider · Type 1 NPI

Brandon Ly, DO

Student in an Organized Health Care Education/Training Program · Riverside, CA

NPI number 1609653492 Active · reactivated Mar 27, 2025

Practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Call (951) 788-3550 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X4521 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609653492

Brandon Ly, DO's National Provider Identifier is 1609653492, issued on Sep 13, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Riverside, CA. The record was last updated on May 1, 2026.