| Life Clinic Medical, Pa | |
|
5525 Cedar Lake Rd S St Louis Park MN 55416-1420 | |
| (866) 240-8437 | |
| (866) 240-9836 |
| Full Name | Life Clinic Medical, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 5525 Cedar Lake Rd S, St Louis Park, Minnesota |
| Authorized Official Name and Position | Kambiz Farbakhsh (OWNER/ FOUNDER) |
| Authorized Official Contact | 8662408437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Clinic Medical, Pa 2902 Corporate Pl Corporate Chanhassen MN 55317-4560 Ph: (866) 240-8437 | Life Clinic Medical, Pa 5525 Cedar Lake Rd S St Louis Park MN 55416-1420 Ph: (866) 240-8437 |
| NPI Number | 1942546692 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 05/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942546692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1865 (Minnesota) | Primary |
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