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

Kelly Ly, PA-C

Individual provider Physician Assistant · NPI 1912742552

Kelly Ly, PA-C is a Physician Assistant in West Covina, California. Qualified in 2025, 1 year ago. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1115 S Sunset Ave
West Covina, CA 91790-3940
Phone: (626) 962-4011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA67134 (CA)

Record details

NPI number1912742552
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 26, 2024
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in West Covina