Provider Demographics
NPI:1265012348
Name:DYQUIANGCO, MONIQUE RAE (DPM)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:RAE
Last Name:DYQUIANGCO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHRADER ST STE 580
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1016
Mailing Address - Country:US
Mailing Address - Phone:415-759-2014
Mailing Address - Fax:415-759-2015
Practice Address - Street 1:1 SHRADER ST STE 580
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-759-2014
Practice Address - Fax:415-759-2015
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE6065213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist