Organization
EL DORADO SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLAUDIA S LOCKWOOD RN (FACILITY DIRECTOR)
(530) 344-1687
Entity
Organization
Contact information
Practice address
4300 GOLDEN CENTER DR, STE E, PLACERVILLE, CA 95667-6278
(530) 344-1687
(530) 344-1561
Mailing address
4300 GOLDEN CENTER DR, STE E, PLACERVILLE, CA 95667-6278
(530) 344-1687
(530) 344-1561
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
030000767
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
354098600
DEPT OF LABOR #
CA
01
—
490005585
RAILROAD #
CA
01
—
AS1560
BLUE CROSS #
CA
01
—
CGP171564
CCS #
CA
05
—
SUR01560F
—
CA
01
—
ZZZH09022
BLUE SHIELD #
CA
Enumeration date
06/14/2005
Last updated
01/24/2013
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