Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Sports Med Spa LLC

Organization Physician Assistant · NPI 1679453781

The Sports Med Spa LLC is a Physician Assistant 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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