Provider Demographics
NPI:1619404696
Name:RICHLIN, BRADLEY (OD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
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:FL 3
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1930
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:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33664152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist