Provider Demographics
NPI:1942269626
Name:RICH, PETER L (O D)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:L
Last Name:RICH
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26611 ALISO CREEK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4805
Mailing Address - Country:US
Mailing Address - Phone:949-362-2200
Mailing Address - Fax:949-362-0249
Practice Address - Street 1:26611 ALISO CREEK RD
Practice Address - Street 2:SUITE B
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4805
Practice Address - Country:US
Practice Address - Phone:949-362-2200
Practice Address - Fax:949-362-0249
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5453T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB226598Medicare UPIN