Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Ivy Medical Clinic Inc

Organization General Practice Physician · NPI 1174934400

Ivy Medical Clinic Inc provides General Practice Physician services in Glendale, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

705 Ivy St
Glendale, CA 91204 Not confirmed with CMS for 12 years — call before visiting
Phone: (818) 945-5523
Fax: (818) 945-5524
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence A23122 (CA)

Record details

NPI number1174934400
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Espinosa — President/Ceo · (818) 945-5523
NPI enumeratedMay 8, 2014
Last updated in NPPESMay 8, 2014
Mailing address705 A Ivy St, Glendale, CA 91204

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