Individual
JEFFREY MERRICK DYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25500 RANCHO NIGUEL ROAD, SUITE 120, LAGUNA NIGUEL, CA 62677
(949) 831-3122
Mailing address
DEPT LA 21789, PASADENA, CA 91185-1789
(949) 263-8620
(800) 409-7005
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A93960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A939600
BS OF CA
CA
05
—
1124129788
—
CA
Enumeration date
09/26/2006
Last updated
10/22/2012
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