CANYON CREST SURGICAL, LLC – NPI #1205071198
Clinic/Center

CANYON CREST SURGICAL, LLC is an AHC clinic located in DRAPER, UT. NPPES has assigned the NPI number 1205071198 to CANYON CREST SURGICAL, LLC on December 08, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CANYON CREST SURGICAL, LLC below.

NPI Profile for
CANYON CREST SURGICAL, LLC

NPI Number
1205071198
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CANYON CREST SURGICAL, LLC
Primary location
11762 S STATE #240
DRAPER, UT 84020
Phone: (801) 542-7194 Fax: (801) 542-7193
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
VICKIE GLAUSER
OFFICE STAFF
Phone: (801) 316-1313
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 UT 2008-ASF-86531

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.