Ivy Medical Clinic INC

NPI #1174934400 in Glendale, California

Provider Information

NPI Number: 1174934400
Entity Type: Organization
Organization Name: Ivy Medical Clinic INC
Primary Specialty: General Practice
Enumeration Date: May 8, 2014
Last Updated: May 8, 2014

Practice Location

Address: 705 IVY ST
City: Glendale
State: California
ZIP Code: 91204
Phone: (818) 945-5523

Authorized Official

Name: DR. OMAR EDUARDO ESPINOSA, M.D.
Title: PRESIDENT/CEO
Phone: (818) 945-5523

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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