Organization
DOMENICK J SISTO M D INC
Active
Other names
LOS ANGELES ORTHOPAEDIC INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DOMENICK J SISTO M.D. (PRESIDENT)
(818) 905-2222
Entity
Organization
Contact information
Practice address
38660 MEDICAL CENTER DRIVE, SUITE A250, PALMDALE, CA 93551-0000
(661) 267-7777
(661) 267-7101
Mailing address
4955 VAN NUYS BLVD, SUITE 615, SHERMAN OAKS, CA 91403-1801
(818) 905-2222
(818) 905-8702
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
061942-71
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA0572
RAILROAD
CA
01
—
W11945B
MEDICARE ID-VALENCIA
CA
01
—
ZZZ36983Z
BLUE SHIELD-SHERMAN OAKS
CA
01
—
ZZZ36984Z
BLUE SHIELD -LANCASTER
CA
Enumeration date
04/17/2006
Last updated
01/27/2023
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