OrganizationActive
Pediatric Allergy
NPI 1689840209 · Pediatric Allergy/Immunology Physician · Salt Lake City, UT
Provider details
- NPI number
- 1689840209
- Entity type
- Organization
- Primary specialty
- Pediatric Allergy/Immunology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Edward Clark, Chairperson
Practice location
100 Mario Capecchi Dr
Pediatric Allergy
Salt Lake City, UT 84113-1103
Phone: (801) 662-2100
Fax: (801) 662-2120
Mailing address
295 Chipeta Way
Salt Lake City, UT 84108-1220
Registry dates
- Enumerated
- 2008-05-03
- Last updated
- 2010-08-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.