Organization
GUSTAVO VELASQUEZ MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO VALESQUEZ MD (OWNER)
(801) 302-7798
Entity
Organization
Contact information
Practice address
4377 W VERMILLION DR, SOUTH JORDAN, UT 84009-7776
(801) 302-7798
Mailing address
4377 W VERMILLION DR, SOUTH JORDAN, UT 84009-7776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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