Custom Eyes Optometry, Inc.
NPI 1548472921ActiveOrganization· Optometrist· Costa Mesa, CA
Optometrist in Costa Mesa, California, registered in NPPES in May 2007. The authorized official on file is Michael Paul Bourgoin, O.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1548472921 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 5, 2007 |
| Last updated in NPPES | Mar 24, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 9870T | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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