Provider Demographics
NPI:1144784398
Name:SEQUOIA PALLIATIVE CARE, LLC
Entity Type:Organization
Organization Name:SEQUOIA PALLIATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-533-7648
Mailing Address - Street 1:SEQUOIA PALLIATIVE CARE, LLC
Mailing Address - Street 2:26940 E. BASELINE ST SUITE 107
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3121
Mailing Address - Country:US
Mailing Address - Phone:909-907-5936
Mailing Address - Fax:909-907-5936
Practice Address - Street 1:26940 BASELINE ST STE 107
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3121
Practice Address - Country:US
Practice Address - Phone:909-907-5936
Practice Address - Fax:909-907-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based