Provider Demographics
NPI:1134100878
Name:RICHLIN, STEVEN BRADLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRADLEY
Last Name:RICHLIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 WILSHIRE BLVD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1937
Mailing Address - Country:US
Mailing Address - Phone:310-276-5333
Mailing Address - Fax:310-276-8830
Practice Address - Street 1:8907 WILSHIRE BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1930
Practice Address - Country:US
Practice Address - Phone:310-276-5333
Practice Address - Fax:310-276-8830
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7836T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0078360Medicaid
CAT70230Medicare UPIN
CA0441380001Medicare NSC
CAWOP7836AMedicare PIN