Organization Name: | MPL GROUP, LLC |
NPI Number: | 1528427804 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL POTTER (PRESIDENT/CONSULT) |
Mailing Address: | 7601 Sunrise Blvd. Suite 8 Citrus Heights |
State: | CA US |
Postal Code: | 95610 |
Phone Number: | 9167216566 |
Fax Number: | |
NPI Enumeration Date: | 02/16/2016 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | RN60585022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |