MEDICARE: DR. ALEX MAGENO 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
1	2084P0800X	Psychiatry Physician	13362821-1205	UT

General Provider Information

NPI Number	:	1538727284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX MAGENO MD

Provider Business Mailing Address
First Line	:	333 W 2230 N STE 225
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6709
Country	:	US
Telephone Number	:	385-230-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W 2230 N STE 225
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6709
Country	:	US
Telephone Number	:	385-230-7799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2019
Last Update Date	:	04/02/2026

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