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Organization
MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY MEDICAL GROUP INC.
Active
Organization
MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURA LYNN STONHAM (BILLING/CREDENTIALING MANAGER)
(916) 731-5955
Entity
Organization
Contact information
Practice address
1700 ALHAMBRA BLVD, SUITE 202, SACRAMENTO, CA 95816-7050
(916) 731-8040
(916) 454-4152
Mailing address
1700 ALHAMBRA BLVD, SUITE 202, SACRAMENTO, CA 95816-7050
(916) 731-8040
(916) 454-4152
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
—
NULL
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
07/08/2006
Last updated
01/17/2022
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