Provider Demographics
NPI:1871816371
Name:DYCO DIAGNOSTICS SERVICES, LLC
Entity Type:Organization
Organization Name:DYCO DIAGNOSTICS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DELA PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-259-4474
Mailing Address - Street 1:222 BRANDYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-5848
Mailing Address - Country:US
Mailing Address - Phone:619-259-4474
Mailing Address - Fax:
Practice Address - Street 1:222 BRANDYWOOD ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-5848
Practice Address - Country:US
Practice Address - Phone:619-259-4474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty