=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710088992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DORI NEILL CAGE M D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 09/06/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8008 FROST ST SUITE #403
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-715-9200
-----------------------------------------------------
Fax | 858-715-9202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8008 FROST ST SUITE #403
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92123-4205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-715-9200
-----------------------------------------------------
Fax | 858-715-9202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. DORI NEILL CAGE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 858-715-9200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0105X
-----------------------------------------------------
Taxonomy Name | Surgery of the Hand (Surgery) Physician
-----------------------------------------------------
License Number | A49579
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------