Provider Demographics
NPI:1619300373
Name:NAFEY, MASOUD (OD)
Entity Type:Individual
Prefix:DR
First Name:MASOUD
Middle Name:
Last Name:NAFEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 PALLADIO PKWY
Mailing Address - Street 2:#2023
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8778
Mailing Address - Country:US
Mailing Address - Phone:916-984-3139
Mailing Address - Fax:916-984-3146
Practice Address - Street 1:330 PALLADIO PKWY
Practice Address - Street 2:#2023
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8778
Practice Address - Country:US
Practice Address - Phone:916-984-3139
Practice Address - Fax:916-984-3146
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14613TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist