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1487007811
JONATHAN LY
SIMI VALLEY, CA
NPI
1487007811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 100404)
Enumeration Date
2016-07-21
Last Update Date
2016-07-21
Business Address
-- JONATHAN LY
1975 ROYAL AVE STE 1
SIMI VALLEY, CA 93065-4603
Phone number: 805-526-3636
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Mailing Address
-- JONATHAN LY
2673 RIKKARD DR
THOUSAND OAKS, CA 91362-4609
Phone number:
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