Individual
GONZALO BARRAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-2507
Mailing address
PO BOX 413037, SALT LAKE CITY, UT 84141-3037
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
8137232-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/13/2010
Last updated
12/05/2017
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