| Dominique Sisto, PA-C | |
|
4955 Van Nuys Blvd, Suite 615, Sherman Oaks, CA 91403-1801 | |
| (818) 905-2222 | |
| Not Available |
| Full Name | Dominique Sisto |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 4955 Van Nuys Blvd, Sherman Oaks, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225431992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 52023 (California) | Primary |
| Entity Name | Domenick J Sisto M D Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710941539 PECOS PAC ID: 0648230292 Enrollment ID: O20041018000646 |
| Mailing Address | Practice Location Address |
|---|---|
| Dominique Sisto, PA-C 24719 Long Valley Rd, Hidden Hills, CA 91302-1261 Ph: Not Available | Dominique Sisto, PA-C 4955 Van Nuys Blvd, Suite 615, Sherman Oaks, CA 91403-1801 Ph: (818) 905-2222 |
Mr. Darcesean Gamble, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4955 Van Nuys Blvd Ste 411, Sherman Oaks, CA 91403 Phone: 818-784-1195 |
Mark Wood, Physician Assistant Medicare: Medicare Enrolled Practice Location: 5000 Van Nuys Blvd Ste 205, Sherman Oaks, CA 91403 Phone: 818-850-2243 Fax: 661-360-6380 |
Heather Tran, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4836 Van Nuys Blvd, Sherman Oaks, CA 91403 Phone: 818-907-7546 Fax: 818-907-9506 |
Ms. Jaclyn Sonia Agopian, MPAP, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4836 Van Nuys Blvd, Sherman Oaks, CA 91403 Phone: 818-907-7546 Fax: 818-907-9506 |
Christina Younan Tossoun, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4955 Van Nuys Blvd Ste 200, Sherman Oaks, CA 91403 Phone: 818-981-1555 |
Lili Yen, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4955 Van Nuys Blvd Ste 502, Sherman Oaks, CA 91403 Phone: 818-325-0200 |
Mark Ashby, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13547 Ventura Blvd Ste 282, Sherman Oaks, CA 91423 Phone: 818-968-4242 Fax: 818-968-4242 |