| Olga Sambu, | |
|
375 S Chipeta Way, Slc, UT 84108-1260 | |
| (801) 581-7766 | |
| Not Available |
| Full Name | Olga Sambu |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 375 S Chipeta Way, Slc, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811464076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 11932196-1206 (Utah) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Revere Health PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
| Mailing Address | Practice Location Address |
|---|---|
| Olga Sambu, 1055 N 500 W, Att: Credentialing, Provo, UT 84604 Ph: (801) 354-8225 | Olga Sambu, 375 S Chipeta Way, Slc, UT 84108-1260 Ph: (801) 581-7766 |
Jake Harrison Umbarger, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3338 S 700 E Ste 300a, Slc, UT 84106 Phone: 801-261-4988 |
Bernardo Fernandez, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2641 E Stringham Ave Apt 303c, Slc, UT 84109 Phone: 559-906-2823 |
Elizabeth Leeanne Darling, PA-C MPAS Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4252 Highland Dr, #200, Slc, UT 84124 Phone: 801-993-1800 Fax: 801-993-1699 |
Devin Faye Petersen, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2995 E Middleton Way, Slc, UT 84124 Phone: 801-597-6419 |
Regan K. Brooks, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4252 Highland Dr., #200, Slc, UT 84124 Phone: 801-993-1800 Fax: 801-993-1699 |
Nancy J Stevenson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4000 S 700 E, Ste 10, Slc, UT 84107 Phone: 801-268-4141 Fax: 801-261-8609 |
Heather Lynn Walton, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2000 Circle Of Hope, Clinic 2e, Slc, UT 84112 Phone: 801-587-4024 Fax: 801-585-3846 |