MEDICARE: PALLIATIVE MEDICINE ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1003296070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALLIATIVE MEDICINE ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	4141 S HIGHLAND DR # 304
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84124-2642
Country	:	US
Telephone Number	:	801-747-0330
Fax Number	:	801-747-2294

Provider Business Practice Location Address
First Line	:	4141 S HIGHLAND DR # 304
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84124-2642
Country	:	US
Telephone Number	:	801-747-0330
Fax Number	:	801-747-2294

Authorized Official
Title or Position	:	OWNER
Name	:	NINO CALFA
Credential	:
Telephone Number	:	801-750-6466

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	05/27/2025

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