Provider Demographics
NPI:1164061461
Name:SEQUOIA QUALITY HEALTH INC
Entity Type:Organization
Organization Name:SEQUOIA QUALITY HEALTH INC
Other - Org Name:SEQUOIA QUALITY HEALTH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:BIJAN
Authorized Official - Last Name:PEZESHKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-205-1890
Mailing Address - Street 1:2011 WILSHIRE BLVD # 300
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3503
Mailing Address - Country:US
Mailing Address - Phone:818-300-8993
Mailing Address - Fax:800-545-0866
Practice Address - Street 1:2007 WILSHIRE BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3519
Practice Address - Country:US
Practice Address - Phone:818-300-8993
Practice Address - Fax:800-545-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty