MEDICARE: RONALD JAMES SAGER MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0625X	Assisted Living Facility (Mental Illness)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730405341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD JAMES SAGER MD INC

Provider Business Mailing Address
First Line	:	1663 DOMINICAN WAY STE 214
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95065-1556
Country	:	US
Telephone Number	:	831-713-5180
Fax Number	:	831-713-5179

Provider Business Practice Location Address
First Line	:	1171 7TH AVE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2714
Country	:	US
Telephone Number	:	831-420-0120
Fax Number	:	831-420-0136

Authorized Official
Title or Position	:	OWNER
Name	:	RONALD JAMES SAGER
Credential	:	MD
Telephone Number	:	831-713-5180

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	11/10/2010

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