Individual provider Active NPI

Lincoln Sison Sison, M.D.

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1982990370
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A152589 Issued in CA
Practice address
1850 Fairway Dr
San Leandro, CA 94577-5629
Phone
(510) 746-0510
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0078844 MD
Internal Medicine Physician 207R00000X A152589 CA Primary

Addresses

Primary practice location

1850 Fairway Dr
San Leandro, CA 94577-5629

Mailing address

1850 Fairway Dr
San Leandro, CA 94577-5629
Phone (510) 746-0510

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsison@cei.elders.org

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A152589CAMDInternal Medicine Physician
D0078844MDMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1982990370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 FAIRWAY DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775629",
            "telephone_number": "510-746-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 FAIRWAY DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775629",
            "telephone_number": "510-746-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISON",
        "first_name": "LINCOLN",
        "middle_name": "SISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0078844",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A152589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsison@cei.elders.org",
            "affiliation": "N",
            "address_1": "1850 Fairway Dr",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945775629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

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