Provider Type Icon

CANYON MEDICAL GROUP LLC NPI 1952599409


NPI Information

NPI: 1952599409
Provider Name: CANYON MEDICAL GROUP LLC

Former Legal Business Name: TREEHOUSE PEDIATRICS & FAMILY CARE LLC

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1624 N 200 E STE 160
LOGAN, UT
ZIP 84341
Phone: (435) 750-5599
Get Directions

CANYON MEDICAL GROUP LLC is a pediatrics in Logan, UT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. CANYON MEDICAL GROUP LLC NPI is 1952599409. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Treehouse Pediatrics & Family Care Llc.

The provider's business location address is:

1624 N 200 E STE 160
LOGAN, UT
ZIP 84341-175
Phone: (435) 750-5599
Fax: (435) 750-0861

The provider's authorized official is Wendy Wimmer .
The authorized official title is Manager and has the following contact phone number (435) 750-5599.

The enumeration date for this NPI number is 10/10/2007 and was last updated on 1/23/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics0708814UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1528291883001MEDICAIDUTAH

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.