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Organization
IVANCICH PODIATRY SERVICES, INC.
Active
Organization
IVANCICH PODIATRY SERVICES, INC.
Active
Other names
Larry M. Ivancich
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY M. IVANCICH D.P.M. (PODIATRIST)
(626) 401-2775
Entity
Organization
Contact information
Practice address
11800 VALLEY BLVD, EL MONTE, CA 91732-3040
(626) 401-2775
(626) 401-9826
Mailing address
PO BOX 660025, ARCADIA, CA 91066-0025
(626) 401-2775
(626) 401-9826
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3249
CA
Other
Enumeration date
02/26/2008
Last updated
09/11/2008
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