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Organization
MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY MEDICAL GRP, INC.
Active
Organization
MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY MEDICAL GRP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN MUSHOLT (BILLING MANAGER)
(916) 731-5955
Entity
Organization
Contact information
Practice address
635 ANDERSON RD, SUITE 1, DAVIS, CA 95616-3505
(530) 756-5040
(530) 756-9140
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
—
—
Other
Enumeration date
07/09/2006
Last updated
10/28/2016
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