Custom Eyes Optometry, Inc.

LBN: Custom Eyes Optometry, Inc.
Custom Eyes Optometry, Inc. is an health care organization with primary practice located at 1835 Newport Blvd Suite A-111, Costa Mesa CA 92627-5031. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Custom Eyes Optometry, Inc. can be contacted via phone (949) 646-4949, or through Bourgoin, Michael Paul via phone (949) 646-4949.

Contact Information

Primary practice address
1835 Newport Blvd Suite A-111 Costa Mesa CA 92627-5031
Phone: (949) 646-4949
Fax: (949) 646-2533
Website:
Map and Directions
Authorized official contact:
Name: Bourgoin, Michael Paul Doctor of Optometry (OD)
Phone: (949) 646-4949

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9870T California

Profile Details

NPI number 1548472921
LBN Legal business name Custom Eyes Optometry, Inc.
DBA Doing business as
Authorized official Bourgoin, Michael Paul Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2007
Last updated Mar 24th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548472921 NPPES
California Other 1720197361 INDIVIDUAL NPI

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