Provider Demographics
NPI:1770773061
Name:BRIMHALL, ANGELA KEAKA (DO, MS)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:KEAKA
Last Name:BRIMHALL
Suffix:
Gender:F
Credentials:DO, MS
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Mailing Address - Street 1:2932 N 1130 W
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8055
Mailing Address - Country:US
Mailing Address - Phone:216-280-1875
Mailing Address - Fax:
Practice Address - Street 1:11760 S 700 E STE 112
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6605
Practice Address - Country:US
Practice Address - Phone:801-882-9995
Practice Address - Fax:801-882-9994
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7915314-1204207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery