Provider Demographics
NPI:1013009307
Name:CENTER FOR ADVANCED EYE CARE, LLC
Entity Type:Organization
Organization Name:CENTER FOR ADVANCED EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZEEN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:775-882-9123
Mailing Address - Street 1:1104 NORTH DIVISION STREET
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3803
Mailing Address - Country:US
Mailing Address - Phone:775-882-9123
Mailing Address - Fax:775-882-6030
Practice Address - Street 1:1104 NORTH DIVISION STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3803
Practice Address - Country:US
Practice Address - Phone:775-882-9123
Practice Address - Fax:775-882-6030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV31824207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-13063Medicaid
NV100502286Medicaid
NV100506942Medicaid
NVV31528Medicare PIN
NVH67309Medicare UPIN
NVU97376Medicare UPIN
NV20-13063Medicaid
NV100502286Medicaid
NVV38145Medicare PIN
NVV101043Medicare PIN