| Kc Medical Enterprise Pllc | |
|
415 South Medical Dr Ste C201 Bountiful UT 84010-4946 | |
| (801) 298-2332 | |
| (801) 298-5018 |
| Full Name | Kc Medical Enterprise Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 415 South Medical Dr Ste C201, Bountiful, Utah |
| Authorized Official Name and Position | Cynthia Canga-siao (PRESIDENT) |
| Authorized Official Contact | 8019923130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kc Medical Enterprise Pllc 415 South Medical Dr Ste C201 Bountiful UT 84010-4946 Ph: (801) 992-3130 | Kc Medical Enterprise Pllc 415 South Medical Dr Ste C201 Bountiful UT 84010-4946 Ph: (801) 298-2332 |
| NPI Number | 1396037206 |
|---|---|
| Provider Enumeration Date | 05/11/2011 |
| Last Update Date | 12/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396037206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 7430003-1205 (Utah) | Primary |
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