Provider Demographics
NPI:1689755498
Name:PARIS E. ROYO, MD INC
Entity Type:Organization
Organization Name:PARIS E. ROYO, MD INC
Other - Org Name:ROYO EYE AND LASER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PARIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-423-2134
Mailing Address - Street 1:320 H ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5834
Mailing Address - Country:US
Mailing Address - Phone:530-743-1872
Mailing Address - Fax:530-743-0427
Practice Address - Street 1:8120 TIMBERLAKE WAY
Practice Address - Street 2:SUITE 211
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5412
Practice Address - Country:US
Practice Address - Phone:916-423-2134
Practice Address - Fax:916-423-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23392ZOtherMEDICARE
CAZZZ23392ZOtherMEDICARE