Healthcare Provider Details

I. General information

NPI: 1295362085
Provider Name (Legal Business Name): CATHERINE T LY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11480 BROOKSHIRE AVE STE 300
DOWNEY CA
90241-5023
US

IV. Provider business mailing address

11480 BROOKSHIRE AVE STE 300
DOWNEY CA
90241-5023
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA185150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: