| Organization Name: | EAST WEST HEALTH PARK CITY |
| NPI Number: | 1376912089 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REGAN ARCHIBALD (PARTNER) |
| Mailing Address: | 1790 Sun Peak Dr Suite B106 Park City |
| State: | UT US |
| Postal Code: | 840986559 |
| Phone Number: | 4356401353 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2015 |
| NPI Last Update Date: | 09/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4803531-1205 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |