Provider Demographics
NPI:1962640565
Name:SAGE MEDICAL INC
Entity Type:Organization
Organization Name:SAGE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TALMADGE
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:CAVINESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-748-6000
Mailing Address - Street 1:101 E REDLANDS BLVD
Mailing Address - Street 2:SUITE # 180
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4775
Mailing Address - Country:US
Mailing Address - Phone:909-748-6000
Mailing Address - Fax:
Practice Address - Street 1:101 E REDLANDS BLVD
Practice Address - Street 2:SUITE # 180
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4775
Practice Address - Country:US
Practice Address - Phone:909-748-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89627261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care