Organization
MD24 SAFE HARBOR MI, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINH NGUYEN (CEO)
(623) 374-7774
Entity
Organization
Contact information
Practice address
14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
(855) 959-1911
Mailing address
14780 W MOUNTAIN VIEW BLVD STE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
(855) 959-1911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11585425
—
AZ
Enumeration date
01/14/2020
Last updated
01/14/2020
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