MEDICARE: MAURICE KAZ O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT4440TPA	CA

General Provider Information

NPI Number	:	1700880564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICE KAZ O.D.

Provider Business Mailing Address
First Line	:	320 H ST
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-5834
Country	:	US
Telephone Number	:	530-743-4453
Fax Number	:	530-743-0427

Provider Business Practice Location Address
First Line	:	8120 TIMBERLAKE WAY
Second Line	:	STE 211
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5414
Country	:	US
Telephone Number	:	916-423-2134
Fax Number	:	916-423-4477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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