LT Proactive Care Clinic Nevada - Farbakhsh PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LT PROACTIVE CARE CLINIC NEVADA - FARBAKHSH PLLC

Doing business as

LT Proactive Care Clinic

Practice address

121 Carnegie St
Henderson, NV 89074-7118

Phone

(702) 802-7357

Fax

(702) 802-7356

NPI assigned

Jan 25, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kambiz Farbakhsh, M.D.NPI 1861446015

Title

Owner/Medical Director

Phone

(612) 554-5257

Specialties & licenses 5

Addresses

Other names 1

• LT Proactive Care Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kambiz Farbakhsh, MD

  • Internal Medicine Physician
  • Marina del Rey, CA
  • NPI 1861446015
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1982061750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CORPORATE PL",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174560",
            "telephone_number": "612-554-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CARNEGIE ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747118",
            "telephone_number": "702-802-7357",
            "fax_number": "702-802-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LT PROACTIVE CARE CLINIC NEVADA - FARBAKHSH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "FARBAKHSH",
        "authorized_official_first_name": "KAMBIZ",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "612-554-5257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LT Proactive Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delrita Lowery-Morgan
• Rita Lowicki
• Levi Leavitt Lozano
• Tatiana Lozano
• LPD2 Limited (Florence)
• LTM Johnson MD PLLC
• George Manuel Lu, MD
• Qing Lu
• Karesha Lucas
• Shawnjerria Nishallen Lucas

• Internal Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.