Healthcare Provider Details

I. General information

NPI: 1720912009
Provider Name (Legal Business Name): GABRIELA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W BELLWOOD LN STE 1
SALT LAKE CITY UT
84123-4494
US

IV. Provider business mailing address

3638 S OLDHAM CIR
WEST VALLEY CITY UT
84120-3267
US

V. Phone/Fax

Practice location:
  • Phone: 702-857-8800
  • Fax:
Mailing address:
  • Phone: 801-860-4495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number227590718
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: