| Custom Eyes Optometry, Inc. | |
|
1835 Newport Blvd, Suite A-111, Costa Mesa, CA 92627-5031 | |
| (949) 646-4949 | |
| (949) 646-2533 |
| Full Name | Custom Eyes Optometry, Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1835 Newport Blvd, Costa Mesa, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548472921 | NPI | - | NPPES |
| 1720197361 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 9870T (California) | Primary |
| Provider Name | Michael P Bourgoin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720197361 PECOS PAC ID: 1557371739 Enrollment ID: I20060503000323 |
| Provider Name | Jean Yoo-bourgoin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457495913 PECOS PAC ID: 2264697051 Enrollment ID: I20120628000490 |
| Provider Name | Keith Michael Wong |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568950657 PECOS PAC ID: 8426306952 Enrollment ID: I20210914001584 |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Eyes Optometry, Inc. 1835 Newport Blvd, Suite A-111, Costa Mesa, CA 92627-5031 Ph: (949) 646-4949 | Custom Eyes Optometry, Inc. 1835 Newport Blvd, Suite A-111, Costa Mesa, CA 92627-5031 Ph: (949) 646-4949 |
Dr. Benjamin J Szu, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3140 Bear St, Costa Mesa, CA 92626 Phone: 714-557-2020 | |
Dr. Kevin Michael Grant, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3140 Bear St, Costa Mesa, CA 92626 Phone: 714-557-2020 | |
Trilogy Eye Medical Group, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1640 Newport Blvd, 220, Costa Mesa, CA 92627 Phone: 949-873-5046 Fax: 949-873-5394 | |
Acuity Eye Group Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1640 Newport Blvd Ste 220, Costa Mesa, CA 92627 Phone: 949-876-5046 Fax: 949-573-5394 | |
Dr. Mimia Wen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2651 Irvine Ave Ste 120, Costa Mesa, CA 92627 Phone: 949-432-7894 Fax: 949-432-7880 | |
Dr. Jack Chia Shea, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2200 Harbor Blvd, Ste D130, Costa Mesa, CA 92627 Phone: 949-642-7882 Fax: 949-642-7792 | |
Dr. Neda Khadem, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1545 Nutmeg Pl, Costa Mesa, CA 92626 Phone: 714-435-1150 Fax: 714-435-1250 |