Organization
LIFE CLINIC MEDICAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMBIZ FARBAKHSH M.D. (OWNER/ FOUNDER)
(866) 240-8437
Entity
Organization
Contact information
Practice address
5525 CEDAR LAKE RD S, ST LOUIS PARK, MN 55416-1420
(866) 240-8437
(866) 240-9836
Mailing address
2902 CORPORATE PL, CORPORATE, CHANHASSEN, MN 55317-4560
(866) 240-8437
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1865
MN
Other
Enumeration date
12/28/2012
Last updated
05/17/2013
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