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MRS. MAN KELLIE LY FNP
NPI 1508389701
Nurse Practitioner - Family in Montebello, CA

Active since July 19, 2017
3106 W BEVERLY BLVD, MONTEBELLO, CA 90640(323) 728-1274 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 1, 2024, Jul 19, 2017 (2 updates tracked since 2017).

About Mrs. Man Kellie Ly Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MAN KELLIE LY FNP (NPI 1508389701) is an individual family provider in Montebello, California, licensed in California (95032279) and active in the NPI registry since July 2017. She maintains a secondary practice location in Montebello.

NPPES Registry Identity

NPI1508389701
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MAN KELLIE LYCredential: FNP
Location Address3106 W BEVERLY BLVDMontebello, CA 90640-2217
Mailing Address711 W Valley View DrFullerton, CA 92835-4077 · (626) 390-2908
Phone(323) 728-1274
Sole ProprietorYes
Enumeration DateJuly 19, 2017
Last NPPES UpdateOctober 1, 20242 updates tracked since enumeration
NPPES CertifiedOctober 1, 2024
✔ NPI 1508389701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95032279
Also ListedRegistered Nurse · Ambulatory CareTaxonomy 163WP2201X · License 615128 (CA)
3106 W BEVERLY BLVD, Montebello, CA 90640
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Secondary Practice Location 1

Location 11817 W Beverly BlvdMontebello, CA 90640-3969 · Phone (323) 721-5524

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONIQUE ALEXANDRIA GONZALEZ-JOHNSON MD
Family Medicine
3106 W BEVERLY BLVD
MONTEBELLO, CA 90640
Los Angeles County (323) 728-1274
OMEGA MEDICAL GROUP INC
Internal Medicine (Nephrology)
3106 W BEVERLY BLVD
MONTEBELLO, CA 90640
Los Angeles County (323) 728-1274
BERTHA A GONZALEZ DO, INC
Exclusive Provider Organization
3106 W BEVERLY BLVD
MONTEBELLO, CA 90640
Los Angeles County (323) 728-1274
DR. BERTHA ALICIA GONZALEZ D.O.
Family Medicine
3106 W BEVERLY BLVD
MONTEBELLO, CA 90640
Los Angeles County (323) 728-1845

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Man Ly's NPI number?

The NPI number for Man Ly is 1508389701. It was assigned to this individual provider in the NPPES registry on July 19, 2017.

Where is Man Ly located?

Man Ly practices at 3106 W Beverly Blvd, Montebello, CA 90640. The listed phone number is (323) 728-1274.

What is Man Ly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Man Ly was last updated on October 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.