NPIMap

Organization Active NPI

El Dorado Community Service Center

Doing business as El Dorado-Lawndale

  • Primary Care Clinic/Center
  • Lawndale, CA
National Provider Identifier
1316039241
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
960000924 Issued in CA
Legal business name
EL DORADO COMMUNITY SERVICE CENTER
Doing business as
El Dorado-Lawndale
Practice address
4023 Marine Ave
Lawndale, CA 90260-1840
Phone
(310) 675-9555
NPI assigned
Sep 28, 2006
Last updated
Oct 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Cynthia Ann Blanks
Title
Executive Director
Phone
(661) 254-6630

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Primary Care Clinic/Center 261QP2300X 960000924 CA Primary

Addresses

Primary practice location

4023 Marine Ave
Lawndale, CA 90260-1840

Mailing address

26460 Summit Cir
Santa Clarita, CA 91350-2991
Phone (661) 254-6630

Other identifiers 2

IdentifierTypeStateIssuer
CMM70643FMedicaidCA
19-136MedicaidCA

Other names 1

  • EL DORADO-LAWNDALE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

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…
O20200602002526 CA Part B Supplier - Opioid Treatment Program (Otp) 4183672645 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Inglewood, CA; San Diego, CA; Newhall, CA; Lawndale, CA

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0951364El Dorado Community Service Center4023 Marine Ave, Lawndale, CA 90260Certificate of waiverFeb 11, 2027

National Provider Directory

National Provider Directory

Locations

26460 Summit Cir
Ofc
Santa Clarita, CA 91350

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1316039241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 SUMMIT CIR",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502991",
            "telephone_number": "661-254-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 MARINE AVE",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601840",
            "telephone_number": "310-675-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO COMMUNITY SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "661-254-6630"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "960000924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70643F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19-136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL DORADO-LAWNDALE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawndale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.