Organization
IVY MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISE L IVY M.D. (CEO/PRESIDENT)
(626) 808-5352
Entity
Organization
Contact information
Practice address
2309 PALOMA ST, PASADENA, CA 91104-4926
(626) 808-5352
Mailing address
2309 PALOMA ST, PASADENA, CA 91104-4926
(626) 808-5352
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A86275
CA
Other
Enumeration date
01/11/2012
Last updated
03/07/2023
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