Provider Demographics
NPI:1033108097
Name:URIEN, DAVID R (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:URIEN
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 1:5430 N PALM AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1900
Mailing Address - Country:US
Mailing Address - Phone:559-432-0606
Mailing Address - Fax:559-432-0608
Practice Address - Street 1:5430 N PALM AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1900
Practice Address - Country:US
Practice Address - Phone:559-432-0606
Practice Address - Fax:559-432-0608
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4936T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0049360Medicare ID - Type Unspecified
CA0158560001Medicare NSC
CAT09828Medicare UPIN