Provider Demographics
NPI:1104673656
Name:EL CAMINO COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:EL CAMINO COMMUNITY COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACULTY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NILES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:310-660-3643
Mailing Address - Street 1:16007 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90506-0003
Mailing Address - Country:US
Mailing Address - Phone:310-660-3643
Mailing Address - Fax:310-660-3828
Practice Address - Street 1:16007 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90506-0003
Practice Address - Country:US
Practice Address - Phone:310-660-3643
Practice Address - Fax:310-660-3828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL CAMINO COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-02
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No251300000XAgenciesLocal Education Agency (LEA)