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NPI Code Detail

MEDICARE: DR. DIANE ALONSO MD

MEDICARE: DR. DIANE ALONSO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204F00000XTransplant Surgery Physician5211258-1205UT

General Provider Information

NPI Number : 1275740607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANE ALONSO MD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-507-3380
Fax Number : 801-507-8343
Provider Business Practice Location Address
First Line : 5171 S COTTONWOOD ST STE 210
Second Line :
City : MURRAY
State : UT
Zip : 84107-5718
Country : US
Telephone Number : 801-507-3380
Fax Number : 801-507-8343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 03/30/2026

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