1467781013 NPI number — PATHWAYS COMMUNITY SERIVCES LLC

Table of content: DR. BRUCE SANFORD LOCKHART M.D. (NPI 1255375630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467781013 NPI number — PATHWAYS COMMUNITY SERIVCES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS COMMUNITY SERIVCES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467781013
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8337 TELEGRAPH RD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PICO RIVERA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90660-4957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-467-5440
Provider Business Mailing Address Fax Number:
562-467-5553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12966 EUCLID ST
Provider Second Line Business Practice Location Address:
200, 220 AND 280
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92840-5200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-823-4770
Provider Business Practice Location Address Fax Number:
714-823-4777
Provider Enumeration Date:
12/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GINTER
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF STATE OPERATIONS
Authorized Official Telephone Number:
657-465-9497

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LEGAL ENTITY # 00801 . This is a "MEDICAL PROVIDER NUMBER 30EV" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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