=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891990867
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOUNTAIN VIEW FAMILY PHYSICIANS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2007
-----------------------------------------------------
Last Update Date | 08/17/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5111 N SCOTTSDALE RD STE 108
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85250-7076
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-224-9218
-----------------------------------------------------
Fax | 602-224-0078
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5111 N SCOTTSDALE RD STE 108
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85250-7076
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-224-9218
-----------------------------------------------------
Fax | 602-224-0078
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN OWNER
-----------------------------------------------------
Name | DR. MICHAEL J BRENNAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 602-224-9218
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------