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NPI Code Detail

MEDICARE: DR. OLIVIA IVY M.D. MPH AAHIVS

MEDICARE: DR. OLIVIA IVY M.D. MPH AAHIVS
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
12083P0901XPublic Health & General Preventive Medicine PhysicianS6386TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S6386OTHERTXTEXAS MEDICAL LICENSE
2322610OTHERLALOUISIANA MEDICAL LICENSE
3MT197947OTHERPAPA TRAINING LICENSE

General Provider Information

NPI Number : 1851693436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLIVIA IVY M.D. MPH AAHIVS
Provider Business Mailing Address
First Line : 6255 W SUNSET BLVD FL 21
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-7422
Country : US
Telephone Number : 323-860-5200
Fax Number : 323-467-7119
Provider Business Practice Location Address
First Line : 2927 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-3721
Country : US
Telephone Number : 512-640-3100
Fax Number : 833-687-1671
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2010
Last Update Date : 01/14/2026

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