Provider Demographics
NPI:1952599979
Name:ROY, RAJU
Entity Type:Individual
Prefix:
First Name:RAJU
Middle Name:
Last Name:ROY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 W CHAPMAN AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2331
Mailing Address - Country:US
Mailing Address - Phone:714-978-6784
Mailing Address - Fax:
Practice Address - Street 1:2140 W CHAPMAN AVE STE 121
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2331
Practice Address - Country:US
Practice Address - Phone:714-978-6784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist