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Contact Information

SAMANTHA MAKPAIBOONVATANA
1909 N WATERMAN AVE STE 3
SAN BERNARDINO, CA92404
 Phone: 909-882-8883
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for SAMANTHA MAKPAIBOONVATANA · (Female)

NPI Number 1043703564
Status Active
Credentials
Entity Individual
Enumeration date 06/09/2018
Last updated 07/04/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 33980TLG
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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