Provider Demographics
NPI:1710088992
Name:DORI NEILL CAGE M D INC
Entity Type:Organization
Organization Name:DORI NEILL CAGE M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DORI
Authorized Official - Middle Name:NEILL
Authorized Official - Last Name:CAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-715-9200
Mailing Address - Street 1:8008 FROST ST
Mailing Address - Street 2:SUITE #403
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4205
Mailing Address - Country:US
Mailing Address - Phone:858-715-9200
Mailing Address - Fax:858-715-9202
Practice Address - Street 1:8008 FROST ST
Practice Address - Street 2:SUITE #403
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-715-9200
Practice Address - Fax:858-715-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA495792086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A495790Medicaid
CAA49579OtherMEDICARE ID
CAW19706OtherMEDICARE PTAN
CAW19706OtherMEDICARE PTAN
CAF07870Medicare UPIN