Provider Demographics
NPI:1063506897
Name:FRYER, DAVID BRYAN
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRYAN
Last Name:FRYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 E OAKMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6931
Mailing Address - Country:US
Mailing Address - Phone:714-893-8260
Mailing Address - Fax:714-893-8625
Practice Address - Street 1:7281 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4212
Practice Address - Country:US
Practice Address - Phone:714-893-8260
Practice Address - Fax:714-893-8625
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)