MRS. MARTHA P MANDUJANO (NPI# 1356446215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356446215 |
| Entity Type | Individual |
| Full Name | MRS. MARTHA P MANDUJANO |
| Credential | PA-C |
| Practice Address |
4745 S 3200 W Salt Lake City UT 84118-2822 |
| Mailing Address |
3536 S 1100 E Salt Lake City UT 84106-2451 |
| Practice Telephone | 8019646214 |
| Practice Fax Number | 8019829232 |
| Mailing Telephone | 8013473520 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 6028041-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4745 S 3200 W |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84118-2822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922084813 | David Mortin Gontrum | Family Medicine | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2005-12-21 |
| 1174962963 | Maria Dalia Garza | Counselor | 4745 S 3200 W, Salt Lake City, UT 84129-2822 | 2013-06-14 |
| 1215238530 | Susanna Benavidez Chapman | Physician Assistant | 4745 S 3200 W, Taylorsville, Salt Lake City, UT 84118-2822 | 2010-11-03 |
| 1548471147 | Linda Stearns | Registered Nurse | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2007-05-24 |
| 1770600918 | Thomas Carlyle Whittaker | Family Medicine | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2007-03-23 |
| 1801992953 | Community Health Centers Inc. | Obstetrics & Gynecology | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2006-09-16 |
| 1902901838 | Phung Kim Do | Physician Assistant | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2006-09-14 |
| 1316923113 | Keith Owen Horwood | Family Medicine | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2005-12-22 |
| 1265419022 | Kathy Jane Pedersen | Family Medicine | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2005-12-22 |
| 1902883721 | Paula Anne Guerra | Family Medicine | 4745 S 3200 W, Salt Lake City, UT 84118-2822 | 2005-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225527500 | Hoan K Doan | Case Manager/Care Coordinator | 3809 West 6200 South, Kearns, UT 84118 | 2018-05-02 |
| 1750664785 | Giao L Tran | Pharmacist | 5586 W 6200 S, Slc, UT 84118 | 2011-09-26 |
| 1982913406 | Brent James Seely | Counselor | 5934 S 8400 W, Kearns, UT 84118 | 2010-10-01 |
| 1558593830 | Easterseals-goodwill Northern Rocky Mountain, Inc. | Early Intervention Provider Agency | 5242 South 4820 West, Att Janet Wade, Kearns, UT 84118 | 2009-08-20 |
| 1063643120 | Phung Matthews | Pharmacist | 1837 West 4700 South, Taylorsville, UT 84118 | 2009-08-06 |
| 1689824963 | Mary Candace Christensen | Social Worker | 3703 West 6200 South, Valley Mental Health Artec - Therapeutic Foster Care, Bennion, UT 84118 | 2008-09-24 |
| 1164695128 | Life's Endeavour | Chiropractor | 2494 West Sharron Drive, Taylorsville, UT 84118 | 2008-04-10 |
| 1750585485 | Wendy Kay Cotting | Pediatrics | Taylorsville Kidscare, 3845 W. 4700 S., Taylorsville, UT 84118 | 2007-06-14 |
| 1720102841 | Wendy Lee Bingham | Physical Therapist | 3845 W. 4700 S., Ihc Taylorsville Health Center, Taylorsville, UT 84118 | 2007-03-16 |
| 1417028952 | Terry Milo Hansen | Optometrist | 2828 West 4700 South, Suite D, West Valley City, UT 84118 | 2006-11-13 |
| Find all providers in zip 84118 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556986 | Brittany Tran | Physician Assistant | 2733 W Redwick Ct, Salt Lake City, UT 84129-5901 | 2020-10-25 |
| 1528674975 | James Christopher Nichols | Physician Assistant | 1746 E 2100 S, Salt Lake City, UT 84106-4165 | 2020-09-21 |
| 1841826971 | David Souza | Physician Assistant | 52 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-03-20 |
| 1134751902 | Jacie Anna Mundahl | Physician Assistant | 8th Ave C St E 80, Salt Lake City, UT 84143-0001 | 2020-02-10 |
| 1336770544 | Kelsey Rae Thompson | Physician Assistant | 3809 S Parkview Dr, Salt Lake City, UT 84124-2322 | 2020-01-28 |
| 1245885458 | Adam Douglas Whitney | Physician Assistant | 1056 E Harrison Ave, Salt Lake City, UT 84105-2445 | 2019-08-05 |
| 1306498654 | Jarred J Entringer | Physician Assistant | 2725 S 700 E Apt K, Salt Lake City, UT 84106-2883 | 2019-07-16 |
| 1588216840 | Christina Thomas | Physician Assistant | 255 N 400 W Apt 5015, Salt Lake City, UT 84103-1568 | 2019-07-16 |
| 1770135022 | Evar Saelee | Physician Assistant | 2630 E Stringham Ave Apt 224a, Salt Lake City, UT 84109-3945 | 2019-07-16 |
| 1982263471 | Ashley Marten | Physician Assistant | 3610 E Cascade Way, Salt Lake City, UT 84109-2307 | 2019-06-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84118 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.