Provider Demographics
NPI:1184949638
Name:LIN, RICHARD KUAN-SHENG (OD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:KUAN-SHENG
Last Name:LIN
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 1:27946 RIDGEBLUFF CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-7200
Mailing Address - Country:US
Mailing Address - Phone:310-218-8811
Mailing Address - Fax:
Practice Address - Street 1:27946 RIDGEBLUFF CT
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-7200
Practice Address - Country:US
Practice Address - Phone:310-218-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10710TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist