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Individual

MS. XUAN GRACE L. LY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-3927
(909) 825-7084
Mailing address
1400 PACIFIC COAST HWY, UNIT #205, HUNTINGTON BEACH, CA 92648-4480
(951) 522-1131

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
53871
CA
1835P1200X
Pharmacotherapy Pharmacist
Primary
53871
CA

Other

Enumeration date
09/10/2008
Last updated
08/02/2022
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