Provider Demographics
NPI:1124187018
Name:SINE, DAVID ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:SINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 HIGH SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-9502
Mailing Address - Country:US
Mailing Address - Phone:559-592-2600
Mailing Address - Fax:559-592-2610
Practice Address - Street 1:216 E PINE ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1750
Practice Address - Country:US
Practice Address - Phone:559-592-2600
Practice Address - Fax:559-592-2610
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54357208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A543570Medicaid
CA00A543570Medicare ID - Type Unspecified
CA00A543570Medicaid