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Individual

MICHAEL J. SISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
550 WASHINGTON ST., SUITE 641, SAN DIEGO, CA 92103-2229
(619) 299-2600
(619) 299-3923
Mailing address
550 WASHINGTON ST., SUITE 641, SAN DIEGO, CA 92103-2229
(619) 299-2600
(619) 299-3923

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G48515
CA
2086S0129X
Vascular Surgery Physician
Primary
G48515
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G485150
CA
Enumeration date
04/10/2006
Last updated
04/16/2013
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