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
1	174400000X	Specialist	PENDING	CA

General Provider Information

NPI Number	:	1316113178
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	:	SUITE 116
City	:	FRESNO
State	:	CA
Zip	:	93727-1528
Country	:	US
Telephone Number	:	559-457-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3727 N FIRST ST
Second Line	:	SUITE 106
City	:	FRESNO
State	:	CA
Zip	:	93726-5628
Country	:	US
Telephone Number	:	559-457-6900
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN L MAFFEO
Credential	:	MD
Telephone Number	:	559-457-5800

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	07/14/2008

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