MEDICARE: IVY COTTAGES III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1356925911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IVY COTTAGES III

Provider Business Mailing Address
First Line	:	16840 MOUNT EDEN ST
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-2518
Country	:	US
Telephone Number	:	714-775-1128
Fax Number	:

Provider Business Practice Location Address
First Line	:	16840 MOUNT EDEN ST
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-2518
Country	:	US
Telephone Number	:	714-775-1128
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	CARMEN RODRIGUEZ
Credential	:
Telephone Number	:	714-775-1128

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	05/18/2021

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1447247333 — BRIGHTON PLACE EAST
Practice Location Address:

8625 LAMAR ST
SPRING VALLEY, CA
91977-2518

Practice Phone: 619-461-3222
Practice Fax: 619-461-3575

1518974542 — B-EAST, LLC
Practice Location Address:

8625 LAMAR ST
SPRING VALLEY, CA
91977-2518

Practice Phone: 619-461-3222
Practice Fax: 619-461-3575

1265590665 — MR. DAVID L BAUER MA
Practice Location Address:

2505 VALLEY DR
VALPARAISO, IN
46383-2518

Practice Phone: 219-477-5646
Practice Fax: 219-462-1579

1922145945 — DR. RONALD EDWARD IZYNSKI I DPM
Practice Location Address:

2501 VALLEY DR
VALPARAISO, IN
46383-2518

Practice Phone: 221-992-1144
Practice Fax: 219-921-5303

1669659249 — RONALD E IZYNSKI DPM PC
Practice Location Address:

2501 VALLEY DR
VALPARAISO, IN
46383-2518

Practice Phone: 219-464-2205
Practice Fax: 219-531-6345

Directions to “IVY COTTAGES III ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.