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General NPI Number Information
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NPI Number | 1760916068
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Entity Type | Organization
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Legal Business Name | EASTERN SIERRA OPTOMETRY
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 293 WILLOW ST
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City | BISHOP
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State | CA
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Zip | 93514-2720
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Country | US
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Telephone | 760-872-7511
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Fax | 760-872-2094
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Provider Business Mailing Address
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Address Line | 293 WILLOW ST
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City | BISHOP
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State | CA
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Zip | 93514-2720
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Country | US
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Telephone | 760-872-7511
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Fax | 760-872-2094
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ERIC I RICHMAN
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Credential | O.D.
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Telephone | 760-872-7511
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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 | 9492
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License Number State | CA
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