South Lake Medical Center Inc.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

SOUTH LAKE MEDICAL CENTER INC.

Practice address

213 S. Euclid Ave.
Pasadena, CA 91101-2717

Phone

(626) 449-8314

NPI assigned

Apr 18, 2007

Last updated

Mar 31, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Everett Wayne Collins, D.C.

Title

Owner/President

Phone

(626) 449-6915

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• South Lake Medical Center Inc

  • Non-Pharmacy Dispensing Site
  • Pasadena, CA
  • NPI 1295092021
  NPPES parent name

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1619193653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S. EUCLID AVE.",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012717",
            "telephone_number": "626-449-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S. EUCLID AVE.",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012717",
            "telephone_number": "626-449-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LAKE MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "626-449-6915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.