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Individual

DR. IGOR SISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
911 NORTHLAND DR, PRINCETON, MN 55371-2172

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32872
SC
207R00000X
Internal Medicine Physician
74296
MN
207R00000X
Internal Medicine Physician
C164561
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
C164561
CA
208M00000X
Hospitalist Physician
Primary
164561
CA
208M00000X
Hospitalist Physician
40933
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-71921
EVERCARE
01
2010579
HIGHMARK BCBS
01
3426296000
KEYSTONE BCBS (PERSONAL CHOICE)
01
611455212
TRICARE
Enumeration date
12/03/2007
Last updated
03/20/2025
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