Provider Demographics
NPI:1720653009
Name:LONGEVII LLC
Entity Type:Organization
Organization Name:LONGEVII LLC
Other - Org Name:VIZITMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:SAKAWA
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-682-0802
Mailing Address - Street 1:4001 S 700 E STE 500
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2523
Mailing Address - Country:US
Mailing Address - Phone:801-682-0802
Mailing Address - Fax:
Practice Address - Street 1:4001 S 700 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2177
Practice Address - Country:US
Practice Address - Phone:801-682-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty