Healthcare Provider Details

I. General information

NPI: 1851706956
Provider Name (Legal Business Name): IRENE PEREGRIN ALVAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 W PLEASANT GROVE BLVD
PLEASANT GROVE UT
84062-3216
US

IV. Provider business mailing address

1446 W PLEASANT GROVE BLVD
PLEASANT GROVE UT
84062-3216
US

V. Phone/Fax

Practice location:
  • Phone: 801-785-5100
  • Fax:
Mailing address:
  • Phone: 801-785-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberU4599
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU4599
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: