Provider Demographics
NPI:1386698181
Name:GAGE, MICHAEL L (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:GAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:833 GREENFIELD AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3672
Mailing Address - Country:US
Mailing Address - Phone:559-584-4764
Mailing Address - Fax:559-584-4726
Practice Address - Street 1:833 GREENFIELD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3672
Practice Address - Country:US
Practice Address - Phone:559-584-4764
Practice Address - Fax:559-584-4726
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2016-09-01
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Provider Licenses
StateLicense IDTaxonomies
CAA86864208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I12444Medicare UPIN
00A868641Medicare PIN