Provider Demographics
NPI:1023660453
Name:WEST GYN SERVICES LLC
Entity type:Organization
Organization Name:WEST GYN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:
Authorized Official - Last Name:PABLO-DUCLERC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-833-0420
Mailing Address - Street 1:509 VILLA FONTANA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7452
Mailing Address - Country:US
Mailing Address - Phone:787-833-0420
Mailing Address - Fax:
Practice Address - Street 1:55 CALLE DOCTOR BASORA
Practice Address - Street 2:EDIFICIO MEDICO VI SUITE 102
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-833-0420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty