Healthcare Provider Details

I. General information

NPI: 1316989932
Provider Name (Legal Business Name): LYRA W. NG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/13/2026
Certification Date: 10/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 N TWIN OAKS VALLEY RD STE 101
SAN MARCOS CA
92069-3477
US

IV. Provider business mailing address

158 N TWIN OAKS VALLEY RD STE 101
SAN MARCOS CA
92069-3477
US

V. Phone/Fax

Practice location:
  • Phone: 858-205-1500
  • Fax: 442-515-3062
Mailing address:
  • Phone: 858-205-1500
  • Fax: 422-515-3062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA76998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: