Healthcare Provider Details

I. General information

NPI: 1972477248
Provider Name (Legal Business Name): PROJECT NEW GEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 W NORTHERN AVE STE B1
GLENDALE AZ
85301-1687
US

IV. Provider business mailing address

4444 W NORTHERN AVE STE B1
GLENDALE AZ
85301-1687
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0651
  • Fax:
Mailing address:
  • Phone: 602-233-0651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE GUERRERO
Title or Position: OWNER
Credential:
Phone: 623-233-0651