Basic Information
| Provider Information | |||||||||
| NPI: | 1689788325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOUW | ||||||||
| FirstName: | LAUNCE | ||||||||
| MiddleName: | GIE-CHUAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 581700 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841581700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012133800 | ||||||||
| FaxNumber: | 8015850124 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 CIRCLE OF HOPE DR | ||||||||
| Address2: | SUITE 4244 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841125550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015850100 | ||||||||
| FaxNumber: | 8015850124 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 12/21/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4977186-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 4977186-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | 4977186-1205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 333581 | 01 | UT | DMBA | OTHER | 96213 | 01 | UT | PEHP | OTHER | 870519691LGW | 01 | UT | EMIA EDUCATORS MUTUAL | OTHER | P00418344 | 01 | UT | RAILROAD MEDICARE | OTHER | 107046715102 | 01 | UT | SELECT HEALTH | OTHER | 311168 | 01 | UT | ALTIUS | OTHER |