Provider Demographics
NPI:1497008858
Name:MORGAN HILL FAMILY WELLNESS
Entity Type:Organization
Organization Name:MORGAN HILL FAMILY WELLNESS
Other - Org Name:MORGAN HILL ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:408-776-0420
Mailing Address - Street 1:15585 MONTEREY ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037
Mailing Address - Country:US
Mailing Address - Phone:408-776-0420
Mailing Address - Fax:408-776-0424
Practice Address - Street 1:15585 MONTEREY ST.
Practice Address - Street 2:SUITE C
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037
Practice Address - Country:US
Practice Address - Phone:408-776-0420
Practice Address - Fax:408-776-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9249171100000X
CAAC14335171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty