Kazan Ivan W. Memorial Clinic – Rural Health Clinic/Center, NPI 1619179751

Kazan Ivan W. Memorial Clinic is a healthcare provider. based in Salt lake city, Utah. specializing in Rural Health Clinic/Center. The NPI Number for Kazan Ivan W. Memorial Clinic is 1619179751

Main info

Organization
Name
Kazan Ivan W. Memorial Clinic
NPI
1619179751
Phone
Not provided
Address
4646 LAKE PARK BLVD
Authorized Official
MR. ALBERTO VASQUEZ ADMINISTRATOR
Enumeration Date
1 June 2007
Last Update Date
25 February 2016
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Kazan Ivan W. Memorial Clinic

  • 4646, Lake Park Boulevard, West Valley City, Salt Lake County, Utah, 84120, United States

    SALT LAKE CITY, UT 841208212

    Phone:

    Type: Mailing

  • Center Street, Escalante, Garfield County, Utah, 84726, United States

    ESCALANTE, UT 847260276

    Phone: (435) 826-4374

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84120)

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Reviews

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Frequently asked questions

How do I look up Kazan Ivan W. Memorial Clinic by NPI?
Use NPI 1619179751 when you need to reference Kazan Ivan W. Memorial Clinic in forms, claims, or directories.
Does this profile mean Kazan Ivan W. Memorial Clinic is currently active?
Yes — Kazan Ivan W. Memorial Clinic appears active in the national provider directory.
Does Kazan Ivan W. Memorial Clinic list a primary specialty?
If you are matching referrals, note Rural Health Clinic/Center for Kazan Ivan W. Memorial Clinic. Clinical services aligned with this taxonomy classification.
Where does public data place Kazan Ivan W. Memorial Clinic?
The snapshot lists Salt Lake City, Utah for Kazan Ivan W. Memorial Clinic; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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