MEDICARE: DR. ZAINAB KAGEN 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	208000000X	Pediatrics Physician	62569-20	WI
2	208000000X	Pediatrics Physician	10188155	UT

General Provider Information

NPI Number	:	1003109794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZAINAB KAGEN MD

Provider Business Mailing Address
First Line	:	295 S CHIPETA WAY STE 14
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1231
Country	:	US
Telephone Number	:	801-585-6943
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 S CHIPETA WAY STE 14
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1231
Country	:	US
Telephone Number	:	801-585-6943
Fax Number	:

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

Provider Enumeration Date	:	05/27/2011
Last Update Date	:	10/03/2024

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Directions to “ DR. ZAINAB KAGEN MD” Practice Location

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