Provider Demographics
NPI:1538504469
Name:SUMSION, SEAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:SUMSION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 PARK MARINA DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2822
Mailing Address - Country:US
Mailing Address - Phone:530-244-2273
Mailing Address - Fax:530-244-2708
Practice Address - Street 1:2801 PARK MARINA DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2822
Practice Address - Country:US
Practice Address - Phone:530-244-2273
Practice Address - Fax:530-244-2708
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9748207W00000X
CA144812207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX362115301Medicaid
TX362115302OtherCSHCN
TX362115301Medicaid