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Tyd Executive Medical Clinic
Medical Specialty Clinic/Center in Glendale, California
NPI 1942570130

Tyd Executive Medical Clinic is a Medical Specialty Clinic/Center based in Glendale, CA and is specialized in Medical Specialty. Tyd Executive Medical Clinic practices in Glendale, CA. The NPI Number for Tyd Executive Medical Clinic is 1942570130 and holds a License No. G44887 (California).

The current practice location address for Tyd Executive Medical Clinic is 411 N Central Ave Ste 305, Glendale, CA and can be reached out via phone at 818-500-0205 and via fax at 818-500-1348.

Location: 411 N Central Ave Ste 305, Glendale, CA, 91203-2020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1942570130
Provider Name
Tyd Executive Medical Clinic
Credential
Provider Entity Type
Organization
Address
411 N Central Ave Ste 305, Glendale, CA, 91203-2020
Phone Number
818-500-0205
Fax Number
818-500-1348
Provider Enumeration Date
01/05/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G44887 01 CA MEDICAID
00G44887 05 CA
institution
Provider Business Practice Location Address Details
Address
411 N Central Ave Ste 305
City
Glendale
State
California
Zip
91203-2020
Phone Number
818-500-0205
Fax Number
818-500-1348
person
Provider Business Mailing Address Details
Address
411 N Central Ave Ste 305
City
Glendale
State
California
Zip
91203-2020
Phone Number
818-500-0205
Fax Number
818-500-1348
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
G44887 (California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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