Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 12235977-1205 | UT |
N | 207RC0000X | Internist - Cardiovascular Disease | 12235977-1205 | UT |
NPI | 1669886164 |
---|---|
Provider Name | Dr. Donya Mohebali |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | St George, UT 84790-2128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2014 |
Last Update Date | 28/09/2021 |