Provider Demographics
NPI:1356129134
Name:FALCO, DYLAN JOSHUA ROXAS (PHARMD)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:JOSHUA ROXAS
Last Name:FALCO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 N TUSTIN ST UNIT 5305
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-7553
Mailing Address - Country:US
Mailing Address - Phone:909-653-3330
Mailing Address - Fax:
Practice Address - Street 1:3010 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-4202
Practice Address - Country:US
Practice Address - Phone:310-478-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist