Provider Demographics
NPI:1205606746
Name:CANDID MEDICAL LLC
Entity type:Organization
Organization Name:CANDID MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-600-2492
Mailing Address - Street 1:74 E 18TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4081
Mailing Address - Country:US
Mailing Address - Phone:541-600-2492
Mailing Address - Fax:541-204-8104
Practice Address - Street 1:541 WILLAMETTE ST STE 205
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2694
Practice Address - Country:US
Practice Address - Phone:541-600-2492
Practice Address - Fax:541-204-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty