Individual
JAIME J PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
441 S REDWOOD RD, SALT LAKE CITY, UT 84104-3539
(801) 973-2588
(801) 973-6985
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5998977-1206
UT
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5998977-1206
STATE LISCENSE
UT
Enumeration date
12/14/2006
Last updated
07/15/2021
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