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

Tiffany Tong Ly

Individual provider Physician Assistant · NPI 1225884554

Tiffany Tong Ly is a Physician Assistant in San Diego, California. Qualified in 2025, 1 year ago. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2024

Practice location Address checks out

4060 Fairmount Ave
San Diego, CA 92105-1608
Phone: (714) 400-5093
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA67669 (CA)

Record details

NPI number1225884554
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 26, 2024
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 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

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