Healthcare Provider Details

I. General information

NPI: 1821992173
Provider Name (Legal Business Name): CELL REPAIR MEDICAL, P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 3500 S
WEST VALLEY CITY UT
84120-3306
US

IV. Provider business mailing address

3800 W 3500 S
WEST VALLEY CITY UT
84120-3306
US

V. Phone/Fax

Practice location:
  • Phone: 385-289-1980
  • Fax: 801-973-0090
Mailing address:
  • Phone: 385-289-1980
  • Fax: 801-973-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CALVIN BEAUGEZ
Title or Position: OWNER
Credential: D.C.
Phone: 385-289-1980