Provider Demographics
NPI:1851561930
Name:GAYLORD, ANN INMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:INMAN
Last Name:GAYLORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:STE. #100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3606
Mailing Address - Country:US
Mailing Address - Phone:714-377-9866
Mailing Address - Fax:
Practice Address - Street 1:12902 BROOKHURST ST
Practice Address - Street 2:STE A
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4881
Practice Address - Country:US
Practice Address - Phone:714-530-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist