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

Ly Phung Lam, OD

Individual provider Optometrist · NPI 1144574732

Ly Phung Lam, OD is an Optometry in Colton, California. Graduated from University of California - School of Optometry in 2012, 14 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California, Massachusetts and Pennsylvania.

Years since qualifying
14
Trained at
University of California - School of Optometry
Licensed in
CA, MA, PA
In the registry since
2012
Specialties on file
3
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

308 N La Cadena Dr
Colton, CA 92324-2946
Phone: (909) 321-4700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 33646 (CA)
Optometrist Taxonomy 152W00000X · Licence OEG002712 (PA)
Optometrist Taxonomy 152W00000X · Licence 4952 (MA)

Record details

NPI number1144574732
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedNovember 4, 2012
Last updated in NPPESAugust 7, 2026
Certification dateAugust 7, 2026
Mailing address437 N Euclid Ave, Ontario, CA 91762-3456

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduated 2012 (14 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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