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General NPI Number Information
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NPI Number | 1831122308
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Entity Type | Organization
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Legal Business Name | MEDICAL VISION TECHNOLOGY OPHTHALMOLOGY GROUP, INC.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3288 BELL RD
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City | AUBURN
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State | CA
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Zip | 95603-9243
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Country | US
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Telephone | 530-886-8835
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Fax | 530-886-8853
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Provider Business Mailing Address
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Address Line | 1700 ALHAMBRA BLVD SUITE 202
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City | SACRAMENTO
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State | CA
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Zip | 95816-7050
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Country | US
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Telephone | 916-731-8040
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Fax | 916-454-4152
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Authorized Official
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Title or Position | COO
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Name | STEVE GABELICH
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Credential |
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Telephone | 916-731-8040
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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 |
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License Number State |
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