Provider Demographics
NPI:1295804144
Name:ROYAL PHARMACY GROUP INC
Entity type:Organization
Organization Name:ROYAL PHARMACY GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /PRESIDENT /PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-282-1338
Mailing Address - Street 1:5115 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5122
Mailing Address - Country:US
Mailing Address - Phone:619-282-1338
Mailing Address - Fax:619-282-1227
Practice Address - Street 1:5115 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5122
Practice Address - Country:US
Practice Address - Phone:619-282-1338
Practice Address - Fax:619-282-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CAPHY 512273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1295804144OtherMEDI-CAL PROVIDER NUMBER
CAPHY57165OtherCALIFORNIA STATE BOARD OF PHARMACY RETAIL PERMIT
0508020OtherNCPDP PROVIDER IDENTIFICATION NUMBER