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Individual

DR. MINA GOHARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1160 E 3900 S, STE G200, SALT LAKE CITY, UT 84124-1202
(801) 268-7766
(201) 270-3395
Mailing address
PO BOX 742382, ATLANTA, GA 30374-2382

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7711982-1205
UT
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
4301088182
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000057838
PTAN
UT
Enumeration date
05/22/2007
Last updated
11/25/2020
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