South Lake Clinic, P.a.
Pediatrics
South Lake Clinic, P.a. is a Minnetonka, Minnesota based Pediatric center with medical specialization in
General Pediatrics. South Lake Clinic, P.a. is doing business as
South Lake Pediatrics.
It is located at
17705 Hutchins Dr, Suite 101, Minnetonka, Minnesota - 55345-4145. They can be contacted on phone at
952-401-8300 and fax number 952-401-8240.
NPI number (Unique professional ID) for South Lake Clinic, P.a. is
1427027184 which was assigned by NPPES on 15 Mar, 2006 and it was last updated on 22 Aug, 2020.
South Lake Clinic, P.a. license number is
556 for Pediatrics (208000000X) in Minnesota.
South Lake Clinic, P.a. is a pediatrician who 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 chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
South Lake Clinic, P.a. basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | South Lake Clinic, P.a. |
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| Other Name : | South Lake Pediatrics |
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Business Address:
South Lake Clinic, P.a. address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 17705 Hutchins Dr, Suite 101
Minnetonka, MN, 55345-4145
United States |
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| Phone Number : | 952-401-8300 |
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| Fax Number : | 952-401-8240 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1427027184 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 15 Mar, 2006 |
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| Last Updated On : | 22 Aug, 2020 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Dalet Dobrin |
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| Authorized Official Credential : | M.D. |
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| Official Title or Position : | OWNER/MEDICAL DIRECTOR |
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| Phone Number : | 952-401-8300 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for South Lake Clinic, P.a. are as mentioned. Primary taxonomy code for South Lake Clinic, P.a. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 556 | MN |
Legacy Identifiers:
Other legacy medical identifiers of South Lake Clinic, P.a. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 16623SO | Other | MN | BCBS |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 17705 Hutchins Dr, Suite 101
Minnetonka, MN, 55345-4145
United States |
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| Phone Number : | 952-401-8300 |
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| Fax Number : | 952-401-8240 |
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Business Location:
Patients can refer following map for directions to
South Lake Clinic, P.a. practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.