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General NPI Number Information
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NPI Number | 1467757229
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Entity Type | Organization
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Legal Business Name | MKA EYE ASSOCIATES
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2742 STEPHEN PL
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City | SANTA MARIA
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State | CA
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Zip | 93455-7470
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Country | US
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Telephone | 805-996-0338
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1343
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93406-1343
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Country | US
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Telephone | 805-996-0338
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MATEEN K ALINIAZEE
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Credential | M.D.
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Telephone | 805-996-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C52071
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License Number State | CA
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