Individual
KEVIN LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3425 S BASCOM AVE STE 200, CAMPBELL, CA 95008-7300
(408) 256-5292
Mailing address
365 LOUISE CT, MILPITAS, CA 95035-6026
(408) 981-2081
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
02/28/2020
Last updated
02/28/2020
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