Provider Demographics
NPI:1063392686
Name:EL CAMINO LLC
Entity type:Organization
Organization Name:EL CAMINO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:EGUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-239-0012
Mailing Address - Street 1:11535 DELLWOOD RD N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4678
Mailing Address - Country:US
Mailing Address - Phone:651-239-0012
Mailing Address - Fax:
Practice Address - Street 1:680 GREENBRIER ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-4424
Practice Address - Country:US
Practice Address - Phone:651-239-0012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care