IVANCICH PODIATRY SERVICES INC. NPI 1306015086

NPI Information

  • NPI: 1306015086
  • Provider Name: IVANCICH PODIATRY SERVICES, INC.
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • Former Legal Business Name: LARRY M. IVANCICH
  • Address: 11800 VALLEY BLVD
    EL MONTE, CA
    ZIP 91732
  • Phone: (626) 401-2775

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NPI Details

IVANCICH PODIATRY SERVICES, INC. is a podiatrist in El Monte, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. IVANCICH PODIATRY SERVICES, INC. NPI is 1306015086. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Larry M. Ivancich.

The provider's business location address is:

11800 VALLEY BLVD
EL MONTE, CA
ZIP 91732-040
Phone: (626) 401-2775
Fax: (626) 401-9826

The provider's authorized official is Larry M. Ivancich .
The authorized official title is Podiatrist and has the following contact phone number (626) 401-2775.

The enumeration date for this NPI number is 2/26/2008 and was last updated on 9/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristE3249CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1T19289MEDICARE UPINCALIFORNIA
21092300001MEDICARE NSCCALIFORNIA
36099570001MEDICARE NSCCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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