MEDICARE: MOBILE EYECARE OF UTAH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3758049934	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245274521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE EYECARE OF UTAH LLC

Provider Business Mailing Address
First Line	:	3665 S 8400 W
Second Line	:	SUITE 100
City	:	MAGNA
State	:	UT
Zip	:	84044-2214
Country	:	US
Telephone Number	:	801-250-5745
Fax Number	:	801-250-5981

Provider Business Practice Location Address
First Line	:	3665 S 8400 W
Second Line	:	SUITE 100
City	:	MAGNA
State	:	UT
Zip	:	84044-2214
Country	:	US
Telephone Number	:	801-250-5745
Fax Number	:	801-250-5981

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHAUN DEAN LARSEN
Credential	:	O.D.
Telephone Number	:	801-250-5745

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	08/26/2010

Similar Medicare Providers

1669458220 — MR. ROBERT L DOUGHER P.T.
Practice Location Address:

3665 S 8400 W , SUITE 210
MAGNA, UT
84044-2214

Practice Phone: 801-250-6733
Practice Fax: 801-250-5038

1073540167 — DR. SHAUN DEAN LARSEN O.D.
Practice Location Address:

3665 S 8400 W , SUITE 100
MAGNA, UT
84044-2214

Practice Phone: 801-250-5745
Practice Fax: 801-250-5981

1255347654 — ADVANCED MOTION PHYSICAL THERAPY INC
Practice Location Address:

3665 S 8400 W , SUITE 210
MAGNA, UT
84044-2214

Practice Phone: 801-250-6733
Practice Fax: 801-250-5038

1972438802 — MARLENE CORONA GODINEZ
Practice Location Address:

3761 S DEER VALLEY DR SPC 149
MAGNA, UT
84044-3033

Practice Phone: 801-793-0871
Practice Fax:

1427743541 — BRANDON BALDERSTON
Practice Location Address:

3665 S 8400 W
MAGNA, UT
84044-4907

Practice Phone: 801-250-9638
Practice Fax: 801-250-3204

1063728996 — SCOTT EDWARD THOMPSON PA-C
Practice Location Address:

3665 S 8400 W , SUITE 110
MAGNA, UT
84044-4907

Practice Phone: 801-250-9638
Practice Fax: 801-250-3204

Directions to “MOBILE EYECARE OF UTAH LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.