Individual
DR. TAWNY KAEOCHINDA FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
200 MERCY CIRCLE, OPHTHALMOLOGY CLINIC, CAMP PENDLETON, CA 92055
(760) 719-3419
Mailing address
200 MERCY CIRCLE, OPHTHALMOLOGY CLINIC, CAMP PENDLETON, CA 92055
(760) 719-3419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13521
CA
152WC0802X
Corneal and Contact Management Optometrist
Primary
13521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12390980
CAQH
—
01
—
CB221880
MEDICARE PTAN
CA
Enumeration date
07/08/2008
Last updated
04/22/2026
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