Organization
LT PROACTIVE CARE CLINIC NEVADA - FARBAKHSH PLLC
Active
Other names
LT Proactive Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMBIZ FARBAKHSH M.D. (OWNER/MEDICAL DIRECTOR)
(612) 554-5257
Entity
Organization
Contact information
Practice address
121 CARNEGIE ST, HENDERSON, NV 89074-7118
(702) 802-7357
(702) 802-7356
Mailing address
2901 CORPORATE PL, CHANHASSEN, MN 55317-4560
(612) 554-5257
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2085B0100X
Body Imaging Physician
—
—
Other
Enumeration date
01/25/2016
Last updated
02/15/2016
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