Basic Information
Provider Information
NPI: 1285871913
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAGE
FirstName: JASON
MiddleName: MATTHEW
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4860 Y STREET
Address2: SUITE 3800
City: SACRAMENTO
State: CA
PostalCode: 95817
CountryCode: US
TelephoneNumber: 9167342937
FaxNumber:  
Practice Location
Address1: 4860 Y ST
Address2: SUITE 3800
City: SACRAMENTO
State: CA
PostalCode: 958172307
CountryCode: US
TelephoneNumber: 9167342937
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/16/2009
LastUpdateDate: 08/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117X20A14054CAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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