Organization
EL DORADO SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA M HEINRICH RN (FACILITY ADMINISTRATOR)
(530) 344-1687
Entity
Organization
Contact information
Practice address
4300 GOLDEN CENTER DR, SUITE E, PLACERVILLE, CA 95667-6278
(530) 344-1687
(530) 344-1561
Mailing address
4300 GOLDEN CENTER DR, SUITE E, PLACERVILLE, CA 95667-6278
(530) 344-1687
(530) 344-1561
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316192826
NPI NUMBER
CA
01
—
P00783630
MEDICARE RAILROAD CARRIER
CA
05
—
SUR01560F
—
CA
Enumeration date
11/25/2008
Last updated
10/15/2024
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