Organization
HUMBOLDT MEDICAL EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B MIZOGUCHI MD (PHYSICIAN)
(707) 443-5685
Entity
Organization
Contact information
Practice address
2434 HARRISON AVE, EUREKA, CA 95501-3219
(707) 443-5685
(707) 443-9880
Mailing address
2434 HARRISON AVE, EUREKA, CA 95501-3219
(707) 443-5685
(707) 443-9880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT 14063 TLG
CA
207W00000X
Ophthalmology Physician
Primary
A70161
CA
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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