Organization
EL DORADO COMMUNITY SERVICE CENTERS
Active
Other names
El Dorado- Van Nuys
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEANJAY SHARMA (PRESIDENT / CEO)
(661) 254-6630
Entity
Organization
Contact information
Practice address
6265 SEPULVEDA BLVD STE 9&10, VAN NUYS, CA 91411-1114
(818) 779-0555
(818) 779-0455
Mailing address
PO BOX 801809, VALENCIA, CA 91380-1809
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
960001034
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70743F
—
CA
05
—
HDC70057F
—
CA
Enumeration date
11/07/2006
Last updated
11/06/2018
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