Provider Demographics
NPI:1518110592
Name:MITCHELL, CAMERON ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 SPYGLASS LN
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-1883
Mailing Address - Country:US
Mailing Address - Phone:510-232-3780
Mailing Address - Fax:
Practice Address - Street 1:2229 SPYGLASS LN
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-1883
Practice Address - Country:US
Practice Address - Phone:510-232-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5436152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist