Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ange Mong Ly, MD

Individual provider Internal Medicine Physician · NPI 1114248218

Ange Mong Ly, MD is an Internal Medicine in Gresham, Oregon. Graduated from Oregon Health Sciences University School of Medicine in 2010, 16 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
16
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
OR
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

24800 SE Stark St
Gresham, OR 97030-3378
Phone: (503) 674-1122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD160078 (OR)

Record details

NPI number1114248218
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 13, 2010
Last updated in NPPESJuly 5, 2013
Mailing address24800 Se Stark St, Gresham, OR 97030-3378

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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