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

Preston Khambounmy

Individual provider Physician Assistant · NPI 1013700194

Preston Khambounmy is a Physician Assistant in Andover, Minnesota. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1434 153rd Ln NW
Andover, MN 55304-2588
Phone: (763) 447-0674
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1013700194
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 22, 2025
Last updated in NPPESMay 22, 2025
Certification dateMay 22, 2025
Mailing address1434 153rd Ln Nw, Andover, MN 55304-2588

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