Individual
DR. GUSTAVO VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4377 W VERMILLION DR, SOUTH JORDAN, UT 84009-7776
(505) 624-5622
(801) 302-7798
Mailing address
7181 S CAMPUS VIEW DR STE 200, WEST JORDAN, UT 84084-4312
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6646826-1205
UT
207Q00000X
Family Medicine Physician
MD2006-0292
NM
207Q00000X
Family Medicine Physician
N7508
TX
Other
Enumeration date
04/10/2007
Last updated
02/12/2026
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