Provider Demographics
NPI:1578230793
Name:SARABENET SEQUEIRA, MD, PC
Entity Type:Organization
Organization Name:SARABENET SEQUEIRA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SARABENET
Authorized Official - Middle Name:
Authorized Official - Last Name:SEQUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-518-9354
Mailing Address - Street 1:141 CAMINO ALTO STE 4
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2219
Mailing Address - Country:US
Mailing Address - Phone:415-634-1004
Mailing Address - Fax:
Practice Address - Street 1:141 CAMINO ALTO STE 4
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2219
Practice Address - Country:US
Practice Address - Phone:415-518-9354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty