| Md24 Safe Harbor Oh, Llc. | |
|
14780 W Mountain View Blvd Ste 110 Surprise AZ 85374-7280 | |
| (623) 374-7774 | |
| (855) 959-1911 |
| Full Name | Md24 Safe Harbor Oh, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 14780 W Mountain View Blvd Ste 110, Surprise, Arizona |
| Authorized Official Name and Position | Linh Nguyen (CEO) |
| Authorized Official Contact | 6233747774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Md24 Safe Harbor Oh, Llc. 14780 W Mountain View Blvd Ste 110 Surprise AZ 85374-7280 Ph: (623) 374-7774 | Md24 Safe Harbor Oh, Llc. 14780 W Mountain View Blvd Ste 110 Surprise AZ 85374-7280 Ph: (623) 374-7774 |
| NPI Number | 1447890876 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 01/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447890876 | NPI | - | NPPES |
| 11585425 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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