Healthcare Provider Details

I. General information

NPI: 1376472589
Provider Name (Legal Business Name): BEACHSIDE OPTOMETRY GERMUNDSEN-FAMILY PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10088 ADAMS AVE
HUNTINGTON BEACH CA
92646-4905
US

IV. Provider business mailing address

10088 ADAMS AVE
HUNTINGTON BEACH CA
92646-4905
US

V. Phone/Fax

Practice location:
  • Phone: 714-962-9377
  • Fax: 714-563-1237
Mailing address:
  • Phone: 714-962-9377
  • Fax: 714-563-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MELISSA ANN GERMUNDSEN
Title or Position: PRESIDENT
Credential: OD
Phone: 714-962-9377