Provider Demographics
NPI:1568434728
Name:FREEMAN, ANNE M (OD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:FREEMAN
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:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720
Mailing Address - Country:US
Mailing Address - Phone:562-598-3160
Mailing Address - Fax:562-598-7383
Practice Address - Street 1:10861 CHERRY ST
Practice Address - Street 2:STE 204
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720
Practice Address - Country:US
Practice Address - Phone:562-598-3160
Practice Address - Fax:562-598-7383
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT10229TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U06511Medicare UPIN
WOP10229CMedicare PIN