Individual
JUAN JOSE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MS
Contact information
Practice address
5171 S COTTONWOOD ST STE 910, SALT LAKE CITY, UT 84107-5759
(801) 507-9950
(801) 507-1492
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-9950
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13448852-1206
UT
Other
Enumeration date
06/14/2023
Last updated
11/24/2025
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