# CAPITAL EYE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1962783928
- **Authorized official:** DR. MITRA AYAZIFAR M.D. (PRESIDENT)
- **Authorized official phone:** (916) 960-9176

## Contact information

- **Practice address:** 9221 SIERRA COLLEGE BLVD, SUITE 130, ROSEVILLE, CA 95661-5919
- **Practice address phone:** (916) 797-6747
- **Practice address fax:** (916) 797-6728
- **Mailing address:** 9221 SIERRA COLLEGE BLVD, SUITE 130, ROSEVILLE, CA 95661-5919
- **Mailing address phone:** (916) 797-6747
- **Mailing address fax:** (916) 797-6728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | C52250 | CA | Yes |

## Other

- **Enumeration date:** 09/06/2011
- **Last updated:** 09/16/2019