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Organization
MARIN EYE CARE
Active
Organization
MARIN EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MOZAYANI OD (OWNER)
(415) 883-9888
Entity
Organization
Contact information
Practice address
440 IGNACIO BLVD, NOVATO, CA 94949-6085
(415) 883-9888
(415) 883-1159
Mailing address
440 IGNACIO BLVD, NOVATO, CA 94949-6085
(415) 883-9888
(415) 883-1159
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
13793T
CA
152W00000X
Optometrist
15419
CA
152W00000X
Optometrist
Primary
9545T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417967225
BLUE SHIELD
CA
Enumeration date
11/17/2017
Last updated
11/09/2023
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