Provider Demographics
NPI:1811332075
Name:PAGE, SARAH JEWEL (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEWEL
Last Name:PAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEWEL
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-0595
Mailing Address - Country:US
Mailing Address - Phone:562-857-6556
Mailing Address - Fax:
Practice Address - Street 1:1900 E 4TH ST
Practice Address - Street 2:FAMILY MEDICINE RESIDENCY PROGRAM
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3962
Practice Address - Country:US
Practice Address - Phone:714-967-4766
Practice Address - Fax:714-967-4548
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14135207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine