Healthcare Provider Details

I. General information

NPI: 1356413918
Provider Name (Legal Business Name): MICHAEL STEVEN CAGLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3875 TAYLOR RD STE A1
LOOMIS CA
95650-9272
US

IV. Provider business mailing address

3875 TAYLOR RD STE A1
LOOMIS CA
95650-9272
US

V. Phone/Fax

Practice location:
  • Phone: 916-652-0411
  • Fax: 916-652-0412
Mailing address:
  • Phone: 916-652-0411
  • Fax: 916-652-0412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number20535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: