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General NPI Number Information
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NPI Number | 1396488623
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Entity Type | Organization
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Legal Business Name | SEQUOIA MULTISPECIALTY MEDICAL GROUP
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 4050 S DEMAREE ST
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City | VISALIA
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State | CA
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Zip | 93277-9476
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Country | US
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Telephone | 559-713-6478
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Fax | 559-345-9667
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Provider Business Mailing Address
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Address Line | PO BOX 6005
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City | VISALIA
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State | CA
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Zip | 93290-6005
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Country | US
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Telephone | 559-713-6478
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEALANI KANEHE SINE
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Credential | M.D.
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Telephone | 559-713-6478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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