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Organization
RICHARD J. MIYAMOTO, O.D
Active
Organization
RICHARD J. MIYAMOTO, O.D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J MIYAMOTO O.D. (OPTOMETRIST)
(310) 538-3937
Entity
Organization
Contact information
Practice address
18525 S WESTERN AVE, GARDENA, CA 90248-3830
(310) 538-3937
(310) 538-6952
Mailing address
18525 S WESTERN AVE, GARDENA, CA 90248-3830
(310) 538-3937
(310) 538-6952
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
10386TPA
CA
152W00000X
Optometrist
11361TPA
CA
152W00000X
Optometrist
Primary
7016TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0070160
—
CA
Enumeration date
02/28/2007
Last updated
05/14/2008
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