Healthcare Provider Details

I. General information

NPI: 1962842922
Provider Name (Legal Business Name): MPET MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2013
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E MAIN AVE STE C
MORGAN HILL CA
95037-3661
US

IV. Provider business mailing address

50 E MAIN AVE STE C
MORGAN HILL CA
95037-3661
US

V. Phone/Fax

Practice location:
  • Phone: 408-782-8500
  • Fax: 408-782-5199
Mailing address:
  • Phone: 408-782-8500
  • Fax: 408-782-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE M SWANSON
Title or Position: CEO
Credential: PH.D. DAOM LAC
Phone: 408-710-6298