| Organization Name: | DEL LAGO MEDICAL INC |
| NPI Number: | 1568733400 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SACHIN DIDDEE (MANAGER/OWNER) |
| Mailing Address: | 12020 S Warner Elliot Loop Ste 101 Phoenix |
| State: | AZ US |
| Postal Code: | 850442700 |
| Phone Number: | 4807511900 |
| Fax Number: | 4807796289 |
| NPI Enumeration Date: | 01/24/2012 |
| NPI Last Update Date: | 02/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |