Healthcare Provider Details

I. General information

NPI: 1891564209
Provider Name (Legal Business Name): DORADOCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 BRISTOL ST FL 6
COSTA MESA CA
92626-7170
US

IV. Provider business mailing address

PO BOX 4604
EL DORADO HILLS CA
95762-0021
US

V. Phone/Fax

Practice location:
  • Phone: 916-655-5333
  • Fax:
Mailing address:
  • Phone: 916-655-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL

VIII. Authorized Official

Name: TAMARA E CARONITE
Title or Position: MANAGER
Credential:
Phone: 916-655-5333