Provider Demographics
NPI:1154909240
Name:KADAKIA, SAGAR RAJESH (DO)
Entity type:Individual
Prefix:
First Name:SAGAR
Middle Name:RAJESH
Last Name:KADAKIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2501
Mailing Address - Country:US
Mailing Address - Phone:415-353-9414
Mailing Address - Fax:415-476-4689
Practice Address - Street 1:520 ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2501
Practice Address - Country:US
Practice Address - Phone:415-353-9414
Practice Address - Fax:415-476-4689
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
CA20A22587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program