Provider Demographics
NPI:1457581928
Name:SEQUOIA ORTHOPAEDIC AND SPINE INSTITUTE INC
Entity Type:Organization
Organization Name:SEQUOIA ORTHOPAEDIC AND SPINE INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:559-733-7888
Mailing Address - Street 1:PO BOX 1833
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-1833
Mailing Address - Country:US
Mailing Address - Phone:559-733-7888
Mailing Address - Fax:
Practice Address - Street 1:1337 S LOVERS LN
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-5249
Practice Address - Country:US
Practice Address - Phone:559-733-7888
Practice Address - Fax:559-733-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-19
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7700207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX77000Medicaid
CE685AMedicare PIN
G97721Medicare UPIN