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Organization
CAPITAL EYE MEDICAL GROUP
Active
Organization
CAPITAL EYE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITRA AYAZIFAR MD (OWNER)
(916) 960-9176
Entity
Organization
Contact information
Practice address
123 MARGARET LN STE A1, GRASS VALLEY, CA 95945-5268
(530) 615-3775
(530) 298-9223
Mailing address
PO BOX 279, ROSEVILLE, CA 95660
(916) 960-9176
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
09/14/2019
Last updated
04/09/2023
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