# MA BO INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MA BO INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275182487
- **Legal business name:** MA BO INC
- **Authorized official:** CAITLIN DANIELLE CACCIATORE (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (801) 485-5055

## Contact information

- **Practice address:** 522 E 100 S, SALT LAKE CITY, UT 84102-1905
- **Practice address phone:** (801) 485-5055
- **Practice address fax:** (801) 467-3296
- **Mailing address:** 522 E 100 S, SALT LAKE CITY, UT 84102-1905
- **Mailing address phone:** (801) 485-5055
- **Mailing address fax:** (801) 467-3296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2019
- **Last updated:** 09/10/2019