Provider Demographics
NPI:1396183521
Name:LY, ALAYNA (DO)
Entity Type:Individual
Prefix:MRS
First Name:ALAYNA
Middle Name:
Last Name:LY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 HIGHWAY 104
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640
Mailing Address - Country:US
Mailing Address - Phone:702-388-8436
Mailing Address - Fax:702-388-8431
Practice Address - Street 1:4001 HIGHWAY 104
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-8803
Practice Address - Country:US
Practice Address - Phone:702-388-8436
Practice Address - Fax:702-388-8431
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A15827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine