Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | G63200 | CA |
NPI | 1124066360 |
---|---|
Provider Name | Susanne Sager |
First Address | West Hills, CA 91307-1973 |
Second Address | West Hills, CA 91307-1973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 08/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050394 | BLUE CROSS (01) | CA |
G63200 | MEDICAL BOARD OF CA (01) | CA |
RHM08608F | (05) | CA |
RHM08609F | (05) | CA |
RHM18553H | (05) | CA |
ZZT40394F | (05) | CA |