Provider Demographics
NPI:1760916068
Name:EASTERN SIERRA OPTOMETRY
Entity Type:Organization
Organization Name:EASTERN SIERRA OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:I
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-872-7511
Mailing Address - Street 1:293 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2720
Mailing Address - Country:US
Mailing Address - Phone:760-872-7511
Mailing Address - Fax:760-872-2094
Practice Address - Street 1:293 WILLOW ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2720
Practice Address - Country:US
Practice Address - Phone:760-872-7511
Practice Address - Fax:760-872-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty