Healthcare Provider Details

I. General information

NPI: 1538997119
Provider Name (Legal Business Name): GAD 3 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 BARING BLVD
SPARKS NV
89434-6735
US

IV. Provider business mailing address

3401 N THANKSGIVING WAY STE 190
LEHI UT
84048-4157
US

V. Phone/Fax

Practice location:
  • Phone: 385-454-5027
  • Fax:
Mailing address:
  • Phone: 385-454-5027
  • Fax: 801-742-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AARON ANDERSON
Title or Position: OWNER
Credential:
Phone: 385-454-5027