Eclat Medical, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A95845 Issued in CA

Legal business name

ECLAT MEDICAL, INC

Practice address

800 Fairmount Ave Ste 410
Pasadena, CA 91105-3154

Phone

(626) 535-0900

Fax

(626) 389-5479

NPI assigned

Apr 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shunpei Iwata, MDNPI 1396931309

Title

Medical Director

Phone

(626) 535-0900

Specialties & licenses 1

Addresses

Other names 1

• Huntington Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shunpei Keith Iwata, M.D.

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1396931309
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1477797306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 HUNTINGTON DR",
            "address_2": "#861",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082640",
            "telephone_number": "626-535-0900",
            "fax_number": "626-389-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE STE 410",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053154",
            "telephone_number": "626-535-0900",
            "fax_number": "626-389-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLAT MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "IWATA",
        "authorized_official_first_name": "SHUNPEI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "626-535-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A95845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntington Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Huntington Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aminta Echeverria
• Evelin Echeverria
• Salvador Echeverria, M.D.
• Alejandro Echeverry, DDS
• Leslie Echiveste, MS
• Anne Edano
• Fatima Eddahbi
• Kalman J Edelman, M.D.
• Opeyemi Edgal
• Deborah Boatwright Edgar, MFT

• Primary Care Clinic/Center in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.