Healthcare Provider Details

I. General information

NPI: 1780335679
Provider Name (Legal Business Name): MARK ORLANDI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 E 3900 S STE 3G
SALT LAKE CITY UT
84124-1326
US

IV. Provider business mailing address

1220 E 3900 S STE 3G
SALT LAKE CITY UT
84124-1326
US

V. Phone/Fax

Practice location:
  • Phone: 801-346-7788
  • Fax:
Mailing address:
  • Phone: 801-346-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1780335679
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: