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General NPI Number Information
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NPI Number | 1104220037
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Entity Type | Organization
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Legal Business Name | SEQUOIA INSTITUTE FOR SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 2318 W SUNNYSIDE AVE
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City | VISALIA
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State | CA
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Zip | 93277-7265
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Country | US
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Telephone | 559-731-2009
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6430
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City | VISALIA
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State | CA
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Zip | 93290-6430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN LIU
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Credential | M.D.
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Telephone | 559-731-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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