Organization
MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURA LYNN STONHAM (BILLING/CREDENTIALING MANAGER)
(916) 731-5955
Entity
Organization
Contact information
Practice address
1700 ALHAMBRA BLVD, SUITE 202, SACRAMENTO, CA 95816-7050
(916) 731-8040
(916) 454-4152
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
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0042240
—
CA
Enumeration date
07/08/2006
Last updated
01/17/2022
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