Provider Demographics
NPI:1396488623
Name:SEQUOIA MULTISPECIALTY MEDICAL GROUP
Entity type:Organization
Organization Name:SEQUOIA MULTISPECIALTY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEALANI
Authorized Official - Middle Name:KANEHE
Authorized Official - Last Name:SINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-713-6478
Mailing Address - Street 1:PO BOX 6005
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-6005
Mailing Address - Country:US
Mailing Address - Phone:559-713-6478
Mailing Address - Fax:
Practice Address - Street 1:4050 S DEMAREE ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9476
Practice Address - Country:US
Practice Address - Phone:559-713-6478
Practice Address - Fax:559-345-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty