Individual provider · NPI-1

Jared Takeshi Aida, D.O.

Physical Medicine & Rehabilitation · Salt Lake City, UT

NPI number1497168272

StatusActive

Last updated in NPPESAug 24, 2023

Details

NPI: 1497168272
Entity type: Individual (NPI-1)
Name: Jared Takeshi Aida
Credential: D.O.
Sex: Male
Sole proprietor: No
Enumeration date: Jun 9, 2014
Certification date: Aug 24, 2023
Last updated: Aug 24, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208100000X	Physical Medicine & Rehabilitation	123456-1205	UT	Yes
2081S0010X	Physical Medicine & Rehabilitation, Sports Medicine	123456-1205	UT

Practice location

1160 E 3900 S Ste 4050
Salt Lake City, UT 84124-1264

Phone 801-262-8486 · Fax 801-284-8699

Mailing address

280 S Main St
Bountiful, UT 84010-6236

Phone 801-505-0821

Other practice locations

2326 N 400 E Ste 102
Tooele, UT 84074

Phone 435-241-6444

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