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General NPI Number Information
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NPI Number | 1962705616
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Entity Type | Organization
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Legal Business Name | DISCHARGE MD, LLC
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 12425 W BELL RD SUITE 200
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City | SURPRISE
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State | AZ
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Zip | 85378-9002
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Country | US
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Telephone | 623-374-7774
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Fax | 623-240-1110
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Provider Business Mailing Address
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Address Line | 12425 W BELL RD SUITE 200
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City | SURPRISE
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State | AZ
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Zip | 85378-9002
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Country | US
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Telephone | 623-374-7774
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Fax | 623-240-1110
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Authorized Official
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Title or Position | CEO
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Name | LINH C NGUYEN
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Credential | M.D.
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Telephone | 623-444-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35198
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License Number State | AZ
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