Provider Demographics
NPI:1275960924
Name:PAGE, ROY CALVIN II (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:CALVIN
Last Name:PAGE
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10474 SANTA MONICA BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6931
Mailing Address - Country:US
Mailing Address - Phone:310-470-2909
Mailing Address - Fax:310-470-3286
Practice Address - Street 1:10474 SANTA MONICA BLVD STE 304
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6931
Practice Address - Country:US
Practice Address - Phone:310-470-2909
Practice Address - Fax:310-470-3286
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor