Individual
DR. JACOB LEO CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N MARIO CAPECCHI DR, DEPARTMENT OF ANESTHESIOLOGY AT PCH, SALT LAKE CITY, UT 84113-1103
(801) 662-3578
(801) 663-3588
Mailing address
100 N MARIO CAPECCHI DR, DEPARTMENT OF ANESTHESIOLOGY AT PCH, SALT LAKE CITY, UT 84113-1103
(801) 662-3578
(801) 663-3588
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2009013294
UT
207LP3000X
Pediatric Anesthesiology Physician
2009013294
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200540240A
—
OK
Enumeration date
06/19/2007
Last updated
06/14/2023
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