Provider Demographics
NPI:1578530747
Name:YORIZANE, SHAW JR (OD, FCOVD)
Entity Type:Individual
Prefix:DR
First Name:SHAW
Middle Name:
Last Name:YORIZANE
Suffix:JR
Gender:M
Credentials:OD, FCOVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 N CEDAR AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3637
Mailing Address - Country:US
Mailing Address - Phone:559-447-5522
Mailing Address - Fax:559-447-5525
Practice Address - Street 1:7411 N CEDAR AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3637
Practice Address - Country:US
Practice Address - Phone:559-447-5522
Practice Address - Fax:559-447-5525
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA06146T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10245Medicare UPIN
CACI205AMedicare PIN