Provider Demographics
NPI:1295920023
Name:UNVERSITY OF UTAH HEALTH CARE
Entity type:Organization
Organization Name:UNVERSITY OF UTAH HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERIATRIC FELLOW
Authorized Official - Prefix:DR
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:SONIA
Authorized Official - Last Name:THAKUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-339-7562
Mailing Address - Street 1:DIVISION OF GERIATRICS UNIVERISITY OF UTAH
Mailing Address - Street 2:30N. 1900E. AB193 SOM
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-587-9103
Mailing Address - Fax:801-585-3884
Practice Address - Street 1:DIVISION OF GERIATRICS UNIVERISITY OF UTAH
Practice Address - Street 2:30N. 1900E. AB193 SOM
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-587-9103
Practice Address - Fax:801-585-3884
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VA SALT LAKE CITY HEALTH CARE SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6004007-1205282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital