Provider Demographics
NPI:1891027272
Name:SHULDINER, RICHARD JEFFREY (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JEFFREY
Last Name:SHULDINER
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 1:761 PAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8494
Mailing Address - Country:US
Mailing Address - Phone:951-898-2020
Mailing Address - Fax:951-898-2021
Practice Address - Street 1:761 PAYETTE DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-8494
Practice Address - Country:US
Practice Address - Phone:951-898-2020
Practice Address - Fax:951-898-2021
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5203T152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation