Provider Demographics
NPI:1386435980
Name:ONG, DIANA LY
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LY
Last Name:ONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LAN
Other - Last Name:LY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8121 GARVALIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3105
Mailing Address - Country:US
Mailing Address - Phone:626-588-7402
Mailing Address - Fax:
Practice Address - Street 1:8121 GARVALIA AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3105
Practice Address - Country:US
Practice Address - Phone:626-588-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH135236183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATCH135236OtherBOARD OF PHARMACY
1154917OtherNATIONAL ASSOCIATION OF BOARDS OF PHARMACY
30037068OtherPHARMACY TECHNICIAN CERTIFICATION BOARD