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Individual

DR. BONNIE LAUREN SAMUELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
21161 NEWPORT COAST DR, NEWPORT BEACH, CA 92657-1123
(949) 640-4733
(949) 287-0186
Mailing address
9862 KINGS CANYON DR, HUNTINGTON BEACH, CA 92646-4829
(714) 745-9312

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34540
CA

Other

Enumeration date
06/23/2020
Last updated
06/23/2020
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