Individual provider · Type 1 NPI

Thirath Mark Luong, PA-C

Physician Assistant · Lakeville, MN

NPI number 1629304654 Active

Practice location

17210 Kenyon Ave
Lakeville, MN 55044-6903

Call (651) 968-5201 Map

Fax (651) 968-5903

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X10898 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1629304654

Thirath Mark Luong, PA-C's National Provider Identifier is 1629304654, issued on Oct 27, 2009. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Lakeville, MN. The record was last updated on Oct 31, 2025.