CANYON CREST SURGICAL LLC NPI 1205071198

NPI Information

NPI: 1205071198
Provider Name: CANYON CREST SURGICAL, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
11762 S STATE #240
DRAPER, UT
ZIP 84020
Phone: (801) 542-7194
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CANYON CREST SURGICAL, LLC is an ambulatory surgical clinic center in Draper, UT. CANYON CREST SURGICAL, LLC NPI is 1205071198. The provider is registered as an organization entity type.

The provider's business location address is:

11762 S STATE #240
DRAPER, UT
ZIP 84020
Phone: (801) 542-7194
Fax: (801) 542-7193

The provider's authorized official is Vickie K Glauser .
The authorized official title is Office Staff and has the following contact phone number (801) 316-1313.

The enumeration date for this NPI number is 12/8/2008 and was last updated on 12/8/2008.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	2008-ASF-86531	UTAH	Yes

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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