Metamorph, Inc.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

17859 Issued in CA

Legal business name

METAMORPH, INC.

Practice address

7725 Kilmarnok Dr
San Jose, CA 95135-2140

Phone

(408) 852-0703

NPI assigned

Oct 25, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phyllis N BornerNPI 1518267582

Title

President

Phone

(408) 852-0703

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phyllis N Borner, PA

  • Physician Assistant
  • San Jose, CA
  • NPI 1518267582
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1902106982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 KILMARNOK DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951352140",
            "telephone_number": "408-852-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 KILMARNOK DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951352140",
            "telephone_number": "408-852-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "BORNER",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-852-0703"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "17859",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "17859",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "17859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley Fernando Mesen, PMHNP
• Rachel Rose Gemilo Mesias
• Charlowe Mesina, MA
• Mestish Mobility LLC
• Metabolic Nutrition Program
• Johari Metobo
• Doug Metz, DPM
• Katherine Martin Metz
• Jamie Marie Meurell
• Stephanie Mew, LMFT

• Physician Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.