NPI 1174934400

Ivy Medical Clinic INC

Organisation General Practice Physician Glendale, CA

Practice location

Address: 705 Ivy St, Glendale, CA 91204
Phone: (818) 945-5523
Fax: (818) 945-5524
Mailing address: 705 a Ivy St, Glendale, CA 91204

Authorised official

Name: Omar Eduardo Espinosa
Title: President/Ceo
Phone: (818) 945-5523

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence A23122 (CA)

Other General Practice providers in California →

Registry record

NPI: 1174934400
Entity type: Organization
NPI issued: 8 May 2014
Record last updated: 8 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.