Individual provider Active NPI

Michael Anthony Sissac, PHARM.D.

  • Pharmacist
  • Cypress, CA
National Provider Identifier
1942600283
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
44554 Issued in CA
Practice address
4597 Chelsea CT
Cypress, CA 90630-3502
Phone
(714) 995-6169
NPI assigned
Aug 22, 2014
Last updated
Aug 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 44554 CA Primary

Addresses

Primary practice location

4597 Chelsea CT
Cypress, CA 90630-3502

Mailing address

4597 Chelsea CT
Cypress, CA 90630-3502
Phone (714) 995-6169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
44554CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1942600283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4597 CHELSEA CT",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303502",
            "telephone_number": "714-995-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4597 CHELSEA CT",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303502",
            "telephone_number": "714-995-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSAC",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "44554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.