IndividualActive
Michael Ly, D.O
NPI 1013014794 · Pediatric Optometrist · Moreno Valley, CA
Provider details
- NPI number
- 1013014794
- Entity type
- Individual
- Primary specialty
- Pediatric OptometristEye and Vision Services Providers
- Credential
- D.O
- Sex
- Male
- Sole proprietor
- Yes
- License
- 11700T (CA)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
22450 Town Cir
Moreno Valley, CA 92553-7506
Phone: (951) 653-1055
Approximate (ZIP-level) locationGet directions
Mailing address
4868 Golden Ridge Dr
Corona, CA 92880-9421
Registry dates
- Enumerated
- 2006-09-17
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.