Eduardo P Siccion, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

C54593 Issued in CA

Practice address

4523 Fruit St
La Verne, CA 91750-2724

Phone

(860) 999-9999

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1083701965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4523 FRUIT ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502724",
            "telephone_number": "860-794-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4523 FRUIT ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502724",
            "telephone_number": "860-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICCION",
        "first_name": "EDUARDO",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "041916",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C54593",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CA",
            "license": "C54593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001419168",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Danielle Serna, DC
• Stephanie Shepard
• Michelle Shin
• Stephanie Shin
• Shirley S. Hirayama DDS
• Asif Siddiq, M.D.
• Leslee Sigala, AMFT
• Monique Nicole Simon
• Ashley Marie Sink
• Sleep Cloud, Trust

• Medical Oncology Physician in La Verne, CA
• Providers in La Verne, CA by specialty
• Medical Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.