Jack Guillermo Sibal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA184052 Issued in OR

Practice address

4940 Hamrick Rd
Central Point, OR 97502-3072

Phone

(541) 690-3600

Fax

(541) 664-3735

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962482042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 HAMRICK RD",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975023072",
            "telephone_number": "541-690-3600",
            "fax_number": "541-664-3735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S. Seaside Ave; Bldg 23",
            "address_2": "ISC San Pedro",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "90731",
            "country_code": "US",
            "telephone_number": "310-732-7500",
            "fax_number": "310-732-7519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBAL",
        "first_name": "JACK",
        "middle_name": "GUILLERMO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "14456",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA184052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin M Schorran, FNP
• Rachel B Schultz, DMD
• Charles Shepherd
• Sage G Sherer, PA-C
• Susan Sherrill, MS QMHP
• Signature Hospice Medford, LLC
• Siskiyou Pacific, Inc.
• Faith Sixkiller
• Kurt Smet, M.S., ATC
• Peggy Joan Smith, RN

• Physician Assistant in Central Point, OR
• Providers in Central Point, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.