Fernando Basco Canon, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

A30070 Issued in CA

Practice address

8337 Telegraph Rd
Suite 210
Pico Rivera, CA 90660-4909

Phone

(562) 806-1321

Fax

(562) 806-0801

NPI assigned

Mar 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Telegraph Dermatology Medical Group Inc

  • Procedural Dermatology Physician
  • Pico Rivera, CA
  • NPI 1245369941
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174656102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8337 TELEGRAPH RD",
            "address_2": "SUITE 210",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604909",
            "telephone_number": "562-806-1321",
            "fax_number": "562-806-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8337 TELEGRAPH RD",
            "address_2": "SUITE 210",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604909",
            "telephone_number": "562-806-1321",
            "fax_number": "562-806-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANON",
        "first_name": "FERNANDO",
        "middle_name": "BASCO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A30070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denice Campos
• Melissa Campos, CD-L
• Julia Isabel Canizal, M.S., CCC-SLP
• Angelica Cano
• Juan Cano
• Johanna G Caprietta
• Elizabeth Caracheo
• Suyan M Carcedo
• Care Medical Office a California Corporation
• Caremore Health Plan

• Procedural Dermatology Physician in Pico Rivera, CA
• Providers in Pico Rivera, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.