Active NPI
Eric Dorado, ATC
- Athletic Trainer
- West Covina, CA
National Provider Identifier
1881153468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000034555
- Practice address
- 1040 E Marbury St
West Covina, CA 91790-2303 - Phone
- (626) 991-2405
- NPI assigned
- Mar 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000034555 | CA | Primary |
Addresses
Primary practice location
1040 E Marbury St
West Covina, CA 91790-2303
Mailing address
1040 E Marbury St
West Covina, CA 91790-2303
Phone (626) 991-2405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000034555 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000034555 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552435200000",
"number": "1881153468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 E MARBURY ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902303",
"telephone_number": "626-991-2405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 E MARBURY ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902303",
"telephone_number": "626-991-2405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORADO",
"first_name": "ERIC",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-13",
"last_updated": "2019-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "2000034555",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2000034555",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.