Organization
EL DORADO COMMUNITY SERVICE CENTER
Active
Other names
INGLEWOOD MEDICAL & MENTAL HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAMESH P SHARMA (DIRECTOR)
(661) 254-6630
Entity
Organization
Contact information
Practice address
4450 W CENTURY BLVD, INGLEWOOD, CA 90304-1504
(310) 671-0555
(310) 674-5292
Mailing address
PO BOX 801809, VALENCIA, CA 91380-1809
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
261QP2300X
Primary Care Clinic/Center
Primary
960000232
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1958
—
CA
05
—
CMM70092F
—
CA
05
—
EAP70092F
—
CA
Enumeration date
06/21/2005
Last updated
09/20/2022
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