MR. IAN DANIEL PRIMAVERA PA-C NPI 1831441237

NPI Information

NPI: 1831441237
Provider Name: MR. IAN DANIEL PRIMAVERA, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
75 N 2260 W
HURRICANE, UT
ZIP 84737
Phone: (760) 757-0224
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MR. Ian Daniel Primavera, PA-C is a medical physician assistant in Hurricane, UT with 12 years of experience. MR. Ian Daniel Primavera, PA-C NPI is 1831441237. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MID WEST MEDICAL COLLEGE
Graduation Year:2012

The provider's business location address is:

75 N 2260 W
HURRICANE, UT
ZIP 84737-034
Phone: (760) 757-0224

The NPI 1831441237 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2012 and was last updated on 7/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	12870631-1206	UTAH	Yes
2	363AM0700X	Physician Assistant	Medical	PA22615	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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