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General NPI Number Information
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NPI Number | 1407407679
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Entity Type | Individual
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Provider Name | FRANCISCO JOSE HURTADO IV PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 125232 S CREEK MEADOW RD UNIT 109
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City | RIVERTON
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State | UT
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Zip | 84065
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Country | US
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Telephone | 801-251-0735
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100253
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City | ATLANTA
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State | GA
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Zip | 30384-0253
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 57136
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License Number State | CA
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