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General NPI Number Information
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NPI Number | 1457329963
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Entity Type | Organization
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Legal Business Name | SEQUOIA SURGERY CENTER, LLC
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 842 S. AKERS ST
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City | VISALIA
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State | CA
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Zip | 93277-8309
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Country | US
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Telephone | 559-740-4094
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Fax | 559-740-4094
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Provider Business Mailing Address
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Address Line | 842 S. AKERS ST
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City | VISALIA
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State | CA
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Zip | 93277-8309
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Country | US
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Telephone | 559-740-4094
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Fax | 559-740-4100
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RENDA A. LIDEN
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Credential |
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Telephone | 559-740-4094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 120000610
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | CA
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