Stephen C Cannon, M.D.
Individual provider Active NPI Otolaryngology Physician · Highland, CA
NPI 1689602013 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689602013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- A70127 (CA)
- Practice address
- 7000 Boulder Ave
Highland, CA 92346-3348 - Phone
- (909) 862-1191
- Fax
- (909) 796-4158
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | A70127 | CA | Yes |
Addresses
Primary practice location
7000 Boulder Ave
Highland, CA 92346-3348
Mailing address
PO Box 2200
Redlands, CA 92373-0722
Phone (909) 793-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A701270 | Medicaid | CA |
Other providers in Highland, CA
- Suzanne Browning
- Cabio Inc
- Elizabeth Cerda Cabrera
- Renee Lee Calderwood
- California Specimen Collection
- Vianey Canseco Heredia
- Marilu Caravez
- Lucy F. Cardona
- Care for Transport LLC
- Andre Carrington
All providers in Highland, CA · Otolaryngology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.