Provider Demographics
NPI:1982767893
Name:SINNO, BASSAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSAM
Middle Name:A
Last Name:SINNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1011 DEVONSHIRE DRIVE
Mailing Address - Street 2:#D
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-942-8426
Mailing Address - Fax:760-635-5632
Practice Address - Street 1:1011 DEVONSHIRE DRIVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024
Practice Address - Country:US
Practice Address - Phone:760-633-3139
Practice Address - Fax:760-635-5632
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC378312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE02553Medicare UPIN