NPIMap

Organization Active NPI

El Dorado Community Service Center

Doing business as El Dorado -Palmdale

  • Community/Behavioral Health Agency
  • Palmdale, CA
National Provider Identifier
1104256601
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
960001031 Issued in CA
Legal business name
EL DORADO COMMUNITY SERVICE CENTER
Doing business as
El Dorado -Palmdale
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
Last updated
May 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Seanjay Sharma
Title
President / Ceo
Phone
(661) 254-6630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 960001031 CA Primary

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 1

  • EL DORADO -PALMDALE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
American Health Services12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2720 E Palmdale Blvd
Ste 129131
Palmdale, CA 93550
Phone (661) 947-3333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1104256601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 SUMMIT CIRCLE",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502991",
            "telephone_number": "661-254-6630",
            "fax_number": "661-254-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E PALMDALE BLVD STE 129-131",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93550",
            "telephone_number": "661-947-3333",
            "fax_number": "661-575-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO COMMUNITY SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "SEANJAY",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "661-254-6630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "960001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL DORADO -PALMDALE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.