Healthcare Provider Details

I. General information

NPI: 1023065265
Provider Name (Legal Business Name): ANNELYNN M CAJAYON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N INDIAN HILL BLVD SUITE C2-101
CLAREMONT CA
91711-4669
US

IV. Provider business mailing address

101 N INDIAN HILL BLVD SUITE C2-101
CLAREMONT CA
91711-4669
US

V. Phone/Fax

Practice location:
  • Phone: 909-621-0979
  • Fax: 909-621-4349
Mailing address:
  • Phone: 909-621-0979
  • Fax: 909-621-4349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number12948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: