Organization
CAPITAL EYE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITRA AYAZIFAR M.D. (PRESIDENT)
(916) 960-9176
Entity
Organization
Contact information
Practice address
9221 SIERRA COLLEGE BLVD, SUITE 130, ROSEVILLE, CA 95661-5919
(916) 797-6747
(916) 797-6728
Mailing address
9221 SIERRA COLLEGE BLVD, SUITE 130, ROSEVILLE, CA 95661-5919
(916) 797-6747
(916) 797-6728
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C52250
CA
Other
Enumeration date
09/06/2011
Last updated
09/16/2019
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