MEDICARE: LORETO R SICAM JR DMD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	39709	CA

General Provider Information

NPI Number	:	1033252150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORETO R SICAM JR DMD INC

Provider Business Mailing Address
First Line	:	699 LEWELLING BLVD
Second Line	:	STE 300
City	:	SAN LEANDRO
State	:	CA
Zip	:	94579-1870
Country	:	US
Telephone Number	:	510-357-8960
Fax Number	:	510-357-8905

Provider Business Practice Location Address
First Line	:	699 LEWELLING BLVD
Second Line	:	STE 300
City	:	SAN LEANDRO
State	:	CA
Zip	:	94579-1870
Country	:	US
Telephone Number	:	510-357-8960
Fax Number	:	510-357-8905

Authorized Official
Title or Position	:	PRESIDENT OWNER DENTIST
Name	:	DR. LORETO R SICAM JR.
Credential	:	DMD
Telephone Number	:	510-357-8960

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1427091289 — LONGS DRUG STORES CALIFORNIA LLC
Practice Location Address:

699 LEWELLING BLVD
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-351-0951
Practice Fax: 510-351-4526

1225184237 — AMY M NGUYEN
Practice Location Address:

699 LEWELLING BLVD , SUITE 286
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-825-6091
Practice Fax:

1366643314 — BRIAN HUNG HAN DMD INC
Practice Location Address:

699 LEWELLING BLVD , SUITE 286
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-347-1350
Practice Fax:

1336512227 — DR. NGOC MY LA PHARMD
Practice Location Address:

699 LEWELLING BLVD
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-351-0951
Practice Fax:

1689035792 — TED CHIN PHARMD
Practice Location Address:

699 LEWELLING BLVD
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-351-0951
Practice Fax: 510-351-4526

1447613401 — TAMMY NGAN RPH
Practice Location Address:

699 LEWELLING BLVD
SAN LEANDRO, CA
94579-1870

Practice Phone: 510-351-0951
Practice Fax:

Directions to “LORETO R SICAM JR DMD INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.