Provider Demographics
NPI:1386366961
Name:DYNASTY GROUP USA LLC
Entity type:Organization
Organization Name:DYNASTY GROUP USA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:DEL REAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:562-587-3518
Mailing Address - Street 1:14251 FIRESTONE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5525
Mailing Address - Country:US
Mailing Address - Phone:562-587-3216
Mailing Address - Fax:
Practice Address - Street 1:14251 FIRESTONE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-5525
Practice Address - Country:US
Practice Address - Phone:562-587-3518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty