| Santibanez Pac Utah | |
|
451 E Bishop Federal Ln Salt Lake City UT 84115-2357 | |
| (801) 487-7557 | |
| Not Available |
| Full Name | Santibanez Pac Utah |
|---|---|
| Speciality | Internal Medicine |
| Location | 451 E Bishop Federal Ln, Salt Lake City, Utah |
| Authorized Official Name and Position | Julie Roser (VP OF OPERATIONS) |
| Authorized Official Contact | 7752220045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santibanez Pac Utah 10775 Double R Blvd Reno NV 89521-8956 Ph: () - | Santibanez Pac Utah 451 E Bishop Federal Ln Salt Lake City UT 84115-2357 Ph: (801) 487-7557 |
| NPI Number | 1881469484 |
|---|---|
| Provider Enumeration Date | 11/24/2023 |
| Last Update Date | 11/24/2023 |
| Medicare PECOS PAC ID | 1355785437 |
|---|---|
| Medicare Enrollment ID | O20240216000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881469484 | NPI | - | NPPES |
| Provider Name | Jorge Santibanez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568446672 PECOS PAC ID: 9739179847 Enrollment ID: I20130709000746 |
| Provider Name | Jason E Crook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194161190 PECOS PAC ID: 2668616038 Enrollment ID: I20130925000385 |
| Provider Name | James Barclay Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992080915 PECOS PAC ID: 9739355595 Enrollment ID: I20150818003529 |
| Provider Name | Stayler Mcomie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932749538 PECOS PAC ID: 3173953106 Enrollment ID: I20200415001642 |
| Provider Name | Chase C Bartholomew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881181618 PECOS PAC ID: 8921345695 Enrollment ID: I20210706000005 |
| Provider Name | Roberta Bostian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972275501 PECOS PAC ID: 4385037514 Enrollment ID: I20230807003019 |
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