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General NPI Number Information
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NPI Number | 1225927171
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Entity Type | Organization
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Legal Business Name | RICHARDSON OD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 605 N WEST KNOLL DR STE B
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-5242
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Country | US
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Telephone | 504-427-3549
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Fax |
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Provider Business Mailing Address
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Address Line | 950 S FAIRFAX AVE APT 520
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City | LOS ANGELES
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State | CA
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Zip | 90036-5692
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Country | US
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Telephone | 504-427-3549
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIELLE RICHARDSON
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Credential | OD
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Telephone | 504-427-3549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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