MEDICARE: PAJE OPTOMETRIC A PROFESSIONAL CORPORATION

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	COR966	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BS942B	OTHER	CA	MEDICARE PTAN
3	W16179	OTHER	CA	MEDICARE PTAN
4	W16179A	OTHER	CA	MEDICARE PTAN
5	BS942C	OTHER	CA	MEDICARE PTAN
6	BS942A	OTHER	CA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073617338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAJE OPTOMETRIC A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	2414 S FAIRVIEW ST
Second Line	:	#103
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5318
Country	:	US
Telephone Number	:	714-557-9492
Fax Number	:	714-557-2548

Provider Business Practice Location Address
First Line	:	2414 S FAIRVIEW ST
Second Line	:	#103
City	:	SANTA ANA
State	:	CA
Zip	:	92704-5318
Country	:	US
Telephone Number	:	714-557-9492
Fax Number	:	714-557-2548

Authorized Official
Title or Position	:	PRESIDENT/ OPTOMETRIST
Name	:	DR. MICHAEL H FIMREITE
Credential	:	OD
Telephone Number	:	714-557-9492

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	08/15/2023

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Directions to “PAJE OPTOMETRIC A PROFESSIONAL CORPORATION ” Practice Location

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