Provider Demographics
NPI:1932289071
Name:STEINER, RICHARD FOREST (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FOREST
Last Name:STEINER
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 1:571 GLENHEATHER DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2056
Mailing Address - Country:US
Mailing Address - Phone:760-736-4148
Mailing Address - Fax:760-736-8246
Practice Address - Street 1:1535 GRAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2465
Practice Address - Country:US
Practice Address - Phone:760-736-4148
Practice Address - Fax:760-736-8246
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6598152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1932289071Medicaid
CACO337AMedicare PIN
CA1932289071Medicaid