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General NPI Number Information
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NPI Number | 1457745705
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Entity Type | Individual
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Provider Name | COURTNEY CAVANAUGH SAGAR MD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax |
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Provider Business Mailing Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | A172896
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A172896
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License Number State | CA
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