El Dorado Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030000033 Issued in CA

Legal business name

EL DORADO CARE CENTER, INC.

Practice address

3280 Washington St
Placerville, CA 95667-5838

Phone

(530) 622-6842

Fax

(530) 622-6814

NPI assigned

Jul 19, 2005

Organization subpart

Yes

Parent organization

HORIZON WEST HEALTHCARE, INC.As reported in NPPES

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

Authorized official

Name

Larry E Bear

Title

Chief Executive Officer

Phone

(916) 624-6230

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• El Dorado Convalescent Hospital, Inc. Former legal business name

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1922007236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SIERRA COLLEGE BLVD",
            "address_2": "STE 190",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773906",
            "telephone_number": "916-624-6230",
            "fax_number": "916-624-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 WASHINGTON ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675838",
            "telephone_number": "530-622-6842",
            "fax_number": "530-622-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HORIZON WEST HEALTHCARE, INC.",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BEAR",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-624-6230"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "030000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR06243G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Dorado Convalescent Hospital, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jason Edward Eberhart-Phillips, MD
• Edca Lifeskill
• Corydon G Edgecomb, OD
• El Dodrado Mental Health
• El Dorado Anesthesia Medical Group
• El Dorado County Community Health C
• El Dorado County Community Health Center
• El Dorado County Community Health Center
• El Dorado County Community Health Center
• El Dorado County Health and Human Services Agency

• Skilled Nursing Facility in Placerville, CA
• Providers in Placerville, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.