Provider Demographics
NPI:1558193375
Name:SEQUOIA HEALTHCARE CENTER
Entity type:Organization
Organization Name:SEQUOIA HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENBO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-469-3400
Mailing Address - Street 1:40657 ROAD 128 STE B
Mailing Address - Street 2:
Mailing Address - City:CUTLER
Mailing Address - State:CA
Mailing Address - Zip Code:93615-2003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40657 ROAD 128 STE B
Practice Address - Street 2:
Practice Address - City:CUTLER
Practice Address - State:CA
Practice Address - Zip Code:93615-2003
Practice Address - Country:US
Practice Address - Phone:510-469-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty