Provider Demographics
NPI:1033106307
Name:CHRISTENSEN, DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:CHRISTENSEN
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 1:220 N MCKEMY AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2654
Mailing Address - Country:US
Mailing Address - Phone:480-961-1865
Mailing Address - Fax:480-961-4605
Practice Address - Street 1:2050 N ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2887
Practice Address - Country:US
Practice Address - Phone:480-786-1075
Practice Address - Fax:480-786-0476
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1018152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ162075Medicare PIN
AZZ162077Medicare PIN
AZZ162078Medicare PIN
AZZ163176Medicare PIN
AZZ163177Medicare PIN
AZZ162074Medicare PIN
AZZ162079Medicare PIN
AZZ162076Medicare PIN
AZZ163181Medicare PIN
AZZ163178Medicare PIN
AZU37572Medicare UPIN
AZZ60437Medicare PIN
AZZ163175Medicare PIN
AZZ163180Medicare PIN