NPIMap

Organization Active NPI

Pacific Eye Surgeons, a California Professional Medical Corporation

  • Eyewear Supplier
  • Hanford, CA
National Provider Identifier
1174322853
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
PACIFIC EYE SURGEONS, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION
Practice address
1395 W Lacey Blvd
Hanford, CA 93230-5904
Phone
(559) 585-3937
Fax
(559) 582-3645
NPI assigned
Mar 13, 2025
Last updated
Feb 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Clifton Chad Bazhaw
Title
Chief Revenue Officer
Phone
(214) 893-0471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1395 W Lacey Blvd
Hanford, CA 93230-5904

Mailing address

3855 Broad St Ste B
San Luis Obispo, CA 93401-7109

Other names 1

  • Kings Eye Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250605003281 CA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 7810947397 Practice locations: Hanford, CA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pacific Eye Surgeons a California Professional Medical Corporation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1174322853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 BROAD ST STE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 W LACEY BLVD",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305904",
            "telephone_number": "559-585-3937",
            "fax_number": "559-582-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYE SURGEONS, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "BAZHAW",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "214-893-0471"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Eye",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.