Organization
DEL LAGO MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SACHIN DIDDEE (MANAGER/OWNER)
(480) 751-1900
Entity
Organization
Contact information
Practice address
12020 S WARNER ELLIOT LOOP, STE 101, PHOENIX, AZ 85044-2700
(480) 751-1900
(480) 779-6289
Mailing address
12020 S WARNER ELLIOT LOOP, STE 101, PHOENIX, AZ 85044-2700
(480) 751-1900
(480) 779-6289
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
670455
—
AZ
Enumeration date
01/24/2012
Last updated
02/06/2012
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