El Dorado Community Service Center
Organization Active NPI Community/Behavioral Health Agency · Palmdale, CA
NPI 1104256601 · NPPES record last updated May 17, 2019
Key facts
- NPI
- 1104256601
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 960001031 (CA)
- Legal business name
- EL DORADO COMMUNITY SERVICE CENTER
- Practice address
- 2720 E Palmdale Blvd Ste 129-131
Palmdale, CA 93550 - Phone
- (661) 947-3333
- Fax
- (661) 575-2397
- NPI assigned
- Nov 19, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. Seanjay Sharma
- Title
- President / Ceo
- Phone
- (661) 254-6630
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 11
Practitioners 1
-
Pedro E Morante, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050111000696 | CA | Part B Supplier - Clinic/Group Practice | 4183672645 |
Receives reassigned benefits from 15 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Azusa, CA; Venice, CA; Van Nuys, CA; San Francisco, CA; Palmdale, CA; Newhall, CA; Los Angeles, CA; Lawndale, CA… |
National Provider Directory
- Tax ID family
- Bakersfield Medical Mental
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 960001031 | CA | Yes |
Addresses
Primary practice location
2720 E Palmdale Blvd Ste 129-131
Palmdale, CA 93550
Mailing address
26460 Summit Circle
Santa Clarita, CA 91350-2991
Phone (661) 254-6630
Other names
- EL DORADO -PALMDALE
Other providers in Palmdale, CA
- Ugo Felicia Edu
- Tory Edwards
- Janel Delavin Eisma
- Karim Eissa
- Chidum Ekpe
- El Dorado Community Service Centers
- Eldorado Community Service Centers
- Elea D. English M.D. Inc
- Elite Surgery Center, LLC
- Elite Surgery Medical Group
All providers in Palmdale, CA · Community/Behavioral Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.