NPIMap

Organization Active NPI

Eldorado Community Service Center

  • Primary Care Clinic/Center
  • Pico Rivera, CA
National Provider Identifier
1174803852
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ELDORADO COMMUNITY SERVICE CENTER
Practice address
8207 Whittier Blvd
Pico Rivera, CA 90660-2521
Phone
(562) 692-2522
Fax
(562) 695-0413
NPI assigned
Aug 25, 2011
Last updated
Aug 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Authorized official

Name
Pramesh P Sharma
Title
Cfo
Phone
(661) 254-6630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

8207 Whittier Blvd
Pico Rivera, CA 90660-2521

Mailing address

PO Box 801809
Valencia, CA 91380-1809
Phone (661) 254-6630

Other identifiers 1

IdentifierTypeStateIssuer
1700882156MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Bakersfield Medical Mental12 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.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1174803852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801809",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913801809",
            "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": "8207 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602521",
            "telephone_number": "562-692-2522",
            "fax_number": "562-695-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDORADO COMMUNITY SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "PRAMESH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "661-254-6630"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700882156",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.