Provider Demographics
NPI:1700576386
Name:SAULOG, CALVIN (DPT)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:SAULOG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20122 LORNE ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-1842
Mailing Address - Country:US
Mailing Address - Phone:818-307-1494
Mailing Address - Fax:
Practice Address - Street 1:7320 WOODLAKE AVE STE 110
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1494
Practice Address - Country:US
Practice Address - Phone:818-676-4508
Practice Address - Fax:818-703-1679
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist