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Individual

MR. KAVON SADEG RAHIMZADEGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A-C

Contact information

Practice address
5848 S FASHION BLVD STE 120, MURRAY, UT 84107-6157
(801) 314-4900
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8424912-1206
UT
363AS0400X
Surgical Physician Assistant
8424912-1206
UT

Other

Enumeration date
09/27/2012
Last updated
12/05/2024
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