Canyon Crest Surgical, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2008-ASF-86531 Issued in UT

Legal business name

CANYON CREST SURGICAL, LLC

Practice address

11762 S State #240
Draper, UT 84020

Phone

(801) 542-7194

Fax

(801) 542-7193

NPI assigned

Dec 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vickie K Glauser

Title

Office Staff

Phone

(801) 316-1313

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1205071198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11762 S STATE #240",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-542-7194",
            "fax_number": "801-542-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11762 S STATE #240",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-542-7194",
            "fax_number": "801-542-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON CREST SURGICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "GLAUSER",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE STAFF",
        "authorized_official_telephone_number": "801-316-1313"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "UT",
            "license": "2008-ASF-86531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candid Utah, P.C.
• Cynthia Rose Canga-Siao, MD
• Krista Canova
• Ruby Alejandra Cantarero
• Canyon Crest Heart & Health L.L.C.
• Jason Capel, LCSW
• Gracyn Capser
• Care One Partners LLC
• Madison Armida Carl
• Avery Carling

• Ambulatory Surgical Clinic/Center in Draper, UT
• Providers in Draper, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.