Provider Demographics
NPI:1750352167
Name:PAGE, WILLIAM R (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:PAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:WRIGHT BLDG. #412
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-346-8555
Mailing Address - Fax:760-346-8666
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:WRIGHT BLDG., #412
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-8555
Practice Address - Fax:760-346-8666
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2010-02-04
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Provider Licenses
StateLicense IDTaxonomies
CAG38630208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G386300Medicaid