# MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720011158
- **Authorized official:** JOANN MUSHOLT (BILLING MGR)
- **Authorized official phone:** (916) 731-5955

## Contact information

- **Practice address:** 120A W COURT ST, WOODLAND, CA 95695-2901
- **Practice address phone:** (530) 668-6000
- **Practice address fax:** (530) 668-9560
- **Mailing address:** 1700 ALHAMBRA BLVD, SUITE 202, SACRAMENTO, CA 95816-7050
- **Mailing address phone:** (916) 731-8040
- **Mailing address fax:** (916) 454-4152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 10/02/2007