Healthcare Provider Details

I. General information

NPI: 1902234867
Provider Name (Legal Business Name): RACHAEL LEIGH HOBBS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 W 930 N
PLEASANT GROVE UT
84062-4104
US

IV. Provider business mailing address

1912 W 930 N
PLEASANT GROVE UT
84062-4104
US

V. Phone/Fax

Practice location:
  • Phone: 801-492-1999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number125693-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: