# MD24 SAFE HARBOR OH, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447890876
- **Authorized official:** LINH NGUYEN MD (CEO)
- **Authorized official phone:** (623) 374-7774

## Contact information

- **Practice address:** 14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
- **Practice address phone:** (623) 374-7774
- **Practice address fax:** (855) 959-1911
- **Mailing address:** 14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
- **Mailing address phone:** (623) 374-7774
- **Mailing address fax:** (855) 959-1911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2020
- **Last updated:** 01/14/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 11585425 | — | AZ |