MEDICARE: DR. PAUL H BASTERMAJIAN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046-010072	IL
2	152W00000X	Optometrist	3974-35	WI
3	152W00000X	Optometrist	18004628A	IN

General Provider Information

NPI Number	:	1033367040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL H BASTERMAJIAN O.D.

Provider Business Mailing Address
First Line	:	1622 COMMONS DR
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-2531
Country	:	US
Telephone Number	:	630-232-8798
Fax Number	:	630-232-8962

Provider Business Practice Location Address
First Line	:	1622 COMMONS DR
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-2531
Country	:	US
Telephone Number	:	630-232-8798
Fax Number	:	630-232-8962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	02/04/2026

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