IVY MEDICAL CLINIC INC – NPI #1174934400
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

IVY MEDICAL CLINIC INC is a provider located in GLENDALE, CA. NPPES has assigned the NPI number 1174934400 to IVY MEDICAL CLINIC INC on May 08, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for IVY MEDICAL CLINIC INC below.

NPI Profile for
IVY MEDICAL CLINIC INC

NPI Number
1174934400
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
IVY MEDICAL CLINIC INC
Primary location
705 IVY ST
GLENDALE, CA 91204
Phone: (818) 945-5523 Fax: (818) 945-5524
Mailing address
705 A IVY ST
GLENDALE, CA 91204
Phone: (818) 945-5523 Fax: (818) 945-5524
Organization Subpart
No
Authorized Official
OMAR ESPINOSA
PRESIDENT/CEO
Phone: (818) 945-5523
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)		 CA A23122

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.