Individual
DR. DENNIS RAOUL RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
573 FIVE CITIES DR, PISMO BEACH, CA 93449-3005
(805) 773-4700
(323) 296-1062
Mailing address
573 FIVE CITIES DR, PISMO BEACH, CA 93449-3005
(213) 999-7885
(323) 296-1062
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8624
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT8624
OPT8624
CA
Enumeration date
11/22/2011
Last updated
05/25/2018
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