Healthcare Provider Details

I. General information

NPI: 1144470980
Provider Name (Legal Business Name): ALAN CONTRERAS SALDIVAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 S COTTONWOOD ST STE 65012TH
MURRAY UT
84107-5704
US

IV. Provider business mailing address

5171 S COTTONWOOD ST STE 650
MURRAY UT
84107-5716
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-9600
  • Fax: 801-507-9601
Mailing address:
  • Phone: 801-507-9600
  • Fax: 801-507-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number12017804-8905
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number12017804-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: