Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Life Clinic Medical, PA

Organization Internal Medicine Physician · NPI 1942546692

Life Clinic Medical, PA is an Internal Medicine Physician in St Louis Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5525 Cedar Lake Rd S
St Louis Park, MN 55416-1420
Phone: (866) 240-8437
Fax: (866) 240-9836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 1865 (MN)

Record details

NPI number1942546692
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kambiz Farbakhsh — Owner/ Founder · (866) 240-8437
NPI enumeratedDecember 28, 2012
Last updated in NPPESMay 17, 2013
Mailing address2902 Corporate Pl, Corporate, Chanhassen, MN 55317-4560

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