Provider Demographics
NPI:1265577761
Name:UYEMURA, ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:UYEMURA
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 1:6760 N WEST AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1396
Mailing Address - Country:US
Mailing Address - Phone:559-226-6701
Mailing Address - Fax:559-226-6703
Practice Address - Street 1:6760 N WEST AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1396
Practice Address - Country:US
Practice Address - Phone:559-226-6701
Practice Address - Fax:559-226-6703
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0076620Medicaid
0350440001Medicare NSC
CAT10576Medicare UPIN
BY214AMedicare PIN