Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

The Sports Med Spa LLC

Organization Physician Assistant · NPI 1679453781

The Sports Med Spa LLC provides Physician Assistant services in West Jordan, Utah. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3580 W 9000 S
West Jordan, UT 84088-8812
Phone: (801) 448-2218
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1679453781
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gibran Borja — Owner · (801) 448-2218
NPI enumeratedSeptember 8, 2025
Last updated in NPPESOctober 16, 2025
Certification dateOctober 16, 2025
Mailing address4645 W S Jordan Pkwy, South Jordan, UT 84009-5761

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