South Lake Clinic, P.A. in Minnetonka - Pediatrics
South Lake Clinic, P.A. - NPI 1427027184
South Lake Clinic, P.A. is a Pediatrics in Minnetonka, Minnesota. South Lake Clinic, P.A. practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for South Lake Clinic, P.A. is 1427027184. The last update date is 2020-08-22.
South Lake Clinic, P.A.'s current location address is 17705 Hutchins Dr, Minnetonka, Minnesota. You can contact this provider via phone number 9524018300 and fax number 9524018240. The mailing address for South Lake Clinic, P.A. is 17705 Hutchins Dr, Minnetonka, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Lake Clinic, P.A. |
|---|---|
| Address | 17705 Hutchins Dr, Minnetonka, Minnesota |
| Phone Number | 9524018300 |
| Fax Number | 9524018240 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/MEDI |
|---|---|
| Authorized Official Name | Dobrin T Dale |
| Credentials | M.D. |
| Telephone Number | 9524018300 |
NPI Number Detail
| NPI Number | 1427027184 |
|---|---|
| Provider Enumeration Date | 2006-03-15 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 17705 Hutchins Dr |
|---|---|
| City | Minnetonka |
| State | Minnesota (MN) |
| Post Code | 553454145 |
| Phone Number | 9524018300 |
| Fax Number | 9524018240 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 556 |
|
Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16623SO | MN | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to South Lake Clinic, P.A. by the Centers for Medicare & Medicaid Services?
The South Lake Clinic, P.A. has been issued the NPI (National Provider Identifier) 1427027184 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where South Lake Clinic, P.A.'s facilities are geographically located?
The facilities of South Lake Clinic, P.A. are physically situated at the following location: 17705 Hutchins Dr, Minnetonka, MN, 553454145.
What is South Lake Clinic, P.A.'s area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for South Lake Clinic, P.A. is Pediatrics, and the taxonomy code that categorizes this field of expertise is 208000000X.
When was the South Lake Clinic, P.A.'s 1427027184 issued?
The South Lake Clinic, P.A.'s 1427027184 was issued on 2006-03-15.
As of what date was the information pertaining to South Lake Clinic, P.A., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to South Lake Clinic, P.A., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.