Individual
CELIA ANAIS PENA HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 N 1900 E RM AB193, SALT LAKE CITY, UT 84132-0002
(801) 585-1686
Mailing address
30 N 1900 E RM AB193, SALT LAKE CITY, UT 84132-0002
(801) 585-1686
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12377479-1205
UT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
12377479-1205
UT
Other
Enumeration date
03/27/2018
Last updated
04/14/2022
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