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NPI Code Detail

MEDICARE: SEQUOIA COMMUNITY HEALTH FOUNDATION, INC.

MEDICARE: SEQUOIA COMMUNITY HEALTH FOUNDATION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366496671
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEQUOIA COMMUNITY HEALTH FOUNDATION, INC.
Provider Business Mailing Address
First Line : 1945 N FINE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93727-1528
Country : US
Telephone Number : 559-457-5283
Fax Number : 559-457-5892
Provider Business Practice Location Address
First Line : 5784 S ELM AVE
Second Line :
City : FRESNO
State : CA
Zip : 93706-5813
Country : US
Telephone Number : 559-457-5600
Fax Number : 559-457-5690
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DR. JOHN L. MAFFEO
Credential : M.D.
Telephone Number : 559-487-7806
Provider Enumeration Date : 05/20/2006
Last Update Date : 01/29/2008

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Directions to “SEQUOIA COMMUNITY HEALTH FOUNDATION, INC. ” Practice Location

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