| Gustavo Carrillo, | |
|
610 S 200 E Ste B, Salt Lake City, UT 84111-3802 | |
| (602) 626-4835 | |
| Not Available |
| Full Name | Gustavo Carrillo |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 610 S 200 E Ste B, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114542255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 12476377-1206 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Utah Hospitals And Clinics | Salt lake city, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Utah Community Physicians Group | 9739403569 | 255 |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo Carrillo, 610 S 200 E Ste B, Salt Lake City, UT 84111-3802 Ph: (801) 539-8617 | Gustavo Carrillo, 610 S 200 E Ste B, Salt Lake City, UT 84111-3802 Ph: (602) 626-4835 |
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