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

Spencer Ryan Ly

Individual provider Occupational Therapist · NPI 1518650951

Spencer Ryan Ly is an Occupational Therapist in Private Practice in Corona, California. Qualified in 2022, 4 years ago. Practices with Fairbanks and Power Physical Therapy Corp, a 54-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

1561 E Ontario Ave Ste 101
Corona, CA 92881-6663
Phone: (951) 407-9233
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 24975 (CA)

Record details

NPI number1518650951
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 31, 2023
Last updated in NPPESAugust 11, 2024
Certification dateAugust 11, 2024

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Fairbanks And Power Physical Therapy Corp — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Corona