Healthcare Provider Details

I. General information

NPI: 1902716186
Provider Name (Legal Business Name): MY LAN ALEXANDRA CHAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MYLAN ALEXANDRA CHAU

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2778 W 12600 S
RIVERTON UT
84065-7204
US

IV. Provider business mailing address

287 E CROSSROADS BLVD UNIT D
SARATOGA SPRINGS UT
84045-3017
US

V. Phone/Fax

Practice location:
  • Phone: 801-837-3125
  • Fax:
Mailing address:
  • Phone: 801-815-9381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number11897042-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: