# SILVER PEAK MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265899009
- **Authorized official:** AMANDA CURTIS (BILLING)
- **Authorized official phone:** (480) 208-6539

## Contact information

- **Practice address:** 1817 S MAIN ST STE 8, SALT LAKE CITY, UT 84115-7060
- **Practice address phone:** (435) 571-0245
- **Practice address fax:** (435) 602-4405
- **Mailing address:** 6300 SAGEWOOD DR STE 123, PARK CITY, UT 84098-7502
- **Mailing address phone:** (435) 571-0245
- **Mailing address fax:** (435) 602-4405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | 5633279 | UT | — |
| 207R00000X | Internal Medicine Physician | 5633279 | UT | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 5633279 | UT | Yes |

## Other

- **Enumeration date:** 01/25/2016
- **Last updated:** 01/25/2016