MEDICARE: EL DORADO SURGERY CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	030000767	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	354098600	OTHER	CA	DEPT OF LABOR #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	AS1560	OTHER	CA	BLUE CROSS #
4	490005585	OTHER	CA	RAILROAD #
5	CGP171564	OTHER	CA	CCS #
6	ZZZH09022	OTHER	CA	BLUE SHIELD #

General Provider Information

NPI Number	:	1508861881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL DORADO SURGERY CENTER, INC.

Provider Business Mailing Address
First Line	:	4300 GOLDEN CENTER DR
Second Line	:	STE E
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6278
Country	:	US
Telephone Number	:	530-344-1687
Fax Number	:	530-344-1561

Provider Business Practice Location Address
First Line	:	4300 GOLDEN CENTER DR
Second Line	:	STE E
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6278
Country	:	US
Telephone Number	:	530-344-1687
Fax Number	:	530-344-1561

Authorized Official
Title or Position	:	FACILITY DIRECTOR
Name	:	MS. CLAUDIA S LOCKWOOD
Credential	:	RN
Telephone Number	:	530-344-1687

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	01/24/2013

Similar Medicare Providers

1033108394 — MR. RONALD EUGENE THOMPSON PT
Practice Location Address:

4300 GOLDEN CENTER DR , SUITE B
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-2045
Practice Fax: 530-642-0794

1033181706 — BRIAN JAMES BAUMGARTNER M.D.
Practice Location Address:

4300 GOLDEN CENTER DR STE D
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-2000
Practice Fax: 530-748-0333

1710936976 — DR. REGINALD DIETEL RICE JR. M.D.
Practice Location Address:

4300 GOLDEN CENTER DR , SUITE D
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-2000
Practice Fax: 530-344-2014

1003867359 — ROBERT JARKA M.D.
Practice Location Address:

4300 GOLDEN CENTER DR , SUITE E
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-1680
Practice Fax:

1225079924 — ANTONY R. BOODY M.D.
Practice Location Address:

4300 GOLDEN CENTER DR , SUITE C
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-2085
Practice Fax: 530-295-0400

1457393639 — WESTERN SIERRA ORTHOPAEDIC CENTER INC
Practice Location Address:

4300 GOLDEN CENTER DR , SUITE C
PLACERVILLE, CA
95667-6278

Practice Phone: 530-344-2070
Practice Fax: 530-295-0400

Directions to “EL DORADO SURGERY CENTER, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.