# ELENA L GONCHAROVA MD PC

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912102997
- **Authorized official:** ELENA L GONCHAROVA MD (PRESIDENT)
- **Authorized official phone:** (801) 475-5100

## Contact information

- **Practice address:** 425 E 5350 S, STE 335, OGDEN, UT 84405-6946
- **Practice address phone:** (801) 475-5100
- **Practice address fax:** (801) 475-8580
- **Mailing address:** PO BOX 150610, OGDEN, UT 84415-0610
- **Mailing address phone:** (801) 476-9200
- **Mailing address fax:** (801) 476-9208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 53786511205 | UT | Yes |

## Other

- **Enumeration date:** 06/19/2007
- **Last updated:** 05/21/2020