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General NPI Number Information
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NPI Number | 1356129134
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Entity Type | Individual
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Provider Name | DYLAN JOSHUA ROXAS FALCO PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 3010 S SEPULVEDA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-4202
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Country | US
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Telephone | 310-478-9821
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 N TUSTIN ST UNIT 5305
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City | ORANGE
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State | CA
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Zip | 92863-7553
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Country | US
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Telephone | 909-653-3330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 88408
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License Number State | CA
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