Provider Demographics
NPI:1386001923
Name:SEQUOIA REGIONAL CANCER CENTER
Entity type:Organization
Organization Name:SEQUOIA REGIONAL CANCER CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-624-3036
Mailing Address - Street 1:4945 W CYPRESS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-1592
Mailing Address - Country:US
Mailing Address - Phone:559-624-3000
Mailing Address - Fax:559-635-4747
Practice Address - Street 1:4945 W CYPRESS AVE STE C
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-1592
Practice Address - Country:US
Practice Address - Phone:559-624-3000
Practice Address - Fax:559-635-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty