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Diamond Lake Clinic, P.C. — NPI 1740669498, Minneapolis, MN | NPI Central

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NPI 1740669498

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Diamond Lake Clinic, P.C.

NPI 1740669498 · Health Service Clinic/Center · Minneapolis, MN

Provider details

NPI number: 1740669498
Entity type: Organization
Primary specialty: Health Service Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Chukwuemeka Anyake, Physician(612) 806-3011
License: 53530 (MN)

Specialties & taxonomies

Health Service Clinic/CenterPrimary261QH0100XLicense 52657 (MN)
Ambulatory Health Care Facilities
Adult Mental Health Clinic/Center261QM0850XLicense 53530 (MN)
Ambulatory Health Care Facilities
Primary Care Clinic/Center261QP2300XLicense 52657 (MN)
Ambulatory Health Care Facilities
Point of Service305S00000XLicense 52657 (MN)
Managed Care Organizations

Practice location

5939 Portland Ave

Minneapolis, MN 55417-3127

Phone: (612) 806-3011

Approximate (ZIP-level) locationGet directions

More MN providers

Mailing address

5939 Portland Ave

Minneapolis, MN 55417-3127

Additional practice locations (1)

1497 White Bear Ave N
Saint Paul, MN 55106-2414
Phone: (612) 869-4444
Fax: (612) 254-8244

Registry dates

Enumerated: 2015-05-27
Last updated: 2025-04-01
Certified: 2025-04-01

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.