Healthcare Provider Details

I. General information

NPI: 1033841895
Provider Name (Legal Business Name): C HUNG GEE PA-C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1868 W 9800 S STE 100
SOUTH JORDAN UT
84095-4713
US

IV. Provider business mailing address

1868 W 9800 S STE 100
SOUTH JORDAN UT
84095-4713
US

V. Phone/Fax

Practice location:
  • Phone: 801-433-2873
  • Fax: 801-433-5734
Mailing address:
  • Phone: 801-433-2873
  • Fax:

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: JANICE ALLRED
Title or Position: MANAGER
Credential:
Phone: 801-285-8848