MEDICARE: PROJECT NEW GEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1972477248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROJECT NEW GEN

Provider Business Mailing Address
First Line	:	4444 W NORTHERN AVE STE B1
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-1687
Country	:	US
Telephone Number	:	602-391-5038
Fax Number	:

Provider Business Practice Location Address
First Line	:	4444 W NORTHERN AVE STE B1
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-1687
Country	:	US
Telephone Number	:	480-729-9294
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	GEORGE GUERRERO
Credential	:
Telephone Number	:	602-391-5038

Provider Enumeration Date	:	09/30/2025
Last Update Date	:	01/14/2026

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Directions to “PROJECT NEW GEN ” Practice Location

Language	Start Address	Practice Location

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