Individual
HORACIO GUILLERMO CARVAJAL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N MARIO CAPECCHI DR RM 4S100, SALT LAKE CITY, UT 84112
(801) 581-6803
Mailing address
30 N MARIO CAPECCHI DR RM 4S100, SALT LAKE CITY, UT 84112
(801) 581-6803
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14271822-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2022
Last updated
02/12/2026
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