Individual
MR. PETER VALLEJO CHAPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1266 ROOSEVELT AVE, SALT LAKE CITY, UT 84105-2542
(801) 487-8964
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104690-1206
UT
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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