Gustavo Carrillo

NPI # 

Practice Address:

610 S 200 E Ste B

Salt Lake City, UT, 84111-3802

Practice Phone:

602-626-4835

License Number:

12476377-1206

License State:

UT

Taxonomy Grouping:

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy Classification:

Physician Assistant

Taxonomy Code:

363A00000X

Updated by NPPES on 12/17/2021. You can view the original data set for NPI # 1114542255 on the official NPPES website. If the information about this NPI provider/company is outdated and you would like to help us update the information, you can Contact Us. This will only update NPI information on NPIScope.com. See our FAQ page for further information on updating NPI information.

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