Organization
SEQUOIA PEDIATRIC ORTHOPAEDICS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LAWRENCE HENNRIKUS JR. M.D. (PRESIDENT)
(559) 324-7300
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, #FE10, MADERA, CA 93638-8761
(559) 353-5944
Mailing address
1187 N WILLOW AVE STE 103, PMB#17, CLOVIS, CA 93611-4411
(559) 324-7300
(559) 324-7350
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
A41574
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085690
—
CA
01
—
ZZZ60690Z
BLUE CROSS & BLUE SHIELD
CA
Enumeration date
01/10/2007
Last updated
08/22/2020
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