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NPI Code Detail

MEDICARE: JOSEPH I. SISON M.D.

MEDICARE:   JOSEPH I. SISON  M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianG71704CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487639001
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH I. SISON M.D.
Provider Business Mailing Address
First Line : PO BOX 19735
Second Line :
City : SACRAMENTO
State : CA
Zip : 95819-0735
Country : US
Telephone Number : 916-529-3907
Fax Number :
Provider Business Practice Location Address
First Line : 4250 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95841-4100
Country : US
Telephone Number : 916-529-3907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 07/08/2007

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