Organization
SOUTH LAKE MEDICAL CENTER INC
Active
Parent organization
SOUTH LAKE MEDICAL CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH LAKE MEDICAL CENTER INC
Authorized official
DR. HAROLD V. MITZELFELT MD (MEDICAL DIRECTOR)
(626) 449-8314
Entity
Organization
Contact information
Practice address
350 S LAKE AVE, STE 280, PASADENA, CA 91101-3530
(626) 449-8314
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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