MEDICARE: MP MEDICAL INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	101308	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922116920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MP MEDICAL INC

Provider Business Mailing Address
First Line	:	6559 EDMONTON AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-2514
Country	:	US
Telephone Number	:	858-449-0131
Fax Number	:	858-866-0688

Provider Business Practice Location Address
First Line	:	6559 EDMONTON AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-2514
Country	:	US
Telephone Number	:	858-449-0131
Fax Number	:	858-866-0688

Authorized Official
Title or Position	:	PRESIDENT MP MEDICAL INC
Name	:	MS. MADELYN C PHILLIPS
Credential	:
Telephone Number	:	858-449-0131

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/28/2008

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Directions to “MP MEDICAL INC ” Practice Location

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