Susan Canning, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G174181 Issued in CA

Practice address

3966 Marcasel Ave
Los Angeles, CA 90066-4616

Phone

(949) 482-1930

Fax

(216) 273-9998

NPI assigned

May 28, 2005

Sex

Female

Sole proprietor

Yes

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

Merit-based Incentive Payment System (MIPS)

Final score

78.03 of 100Reported as group

Quality

78.11

Improvement activities

40

Cost

33.57

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Susan Canning

  • Medical Specialty Clinic/Center
  • Silver Spring, MD
  • NPI 1104086289
  NPD (past) Authorized official
• Advanced Dermatology of Maryland PC

  • Dermatology Physician
  • Fort Washington, MD
  • NPI 1386479004
  NPD (past)
• Greater Washington Dermatology PA

  • Specialist
  • Rockville, MD
  • NPI 1174736516
  NPD (past)

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

{
    "created_epoch": "1117238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680912000000",
    "number": "1689677122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13600 MARINA POINTE DR UNIT 1507",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902929253",
            "telephone_number": "301-704-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3966 MARCASEL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664616",
            "telephone_number": "949-482-1930",
            "fax_number": "216-273-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10621 Church St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917306834",
            "country_code": "US",
            "telephone_number": "909-944-0486",
            "fax_number": "909-944-0486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNING",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-28",
        "last_updated": "2023-04-08",
        "certification_date": "2023-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G174181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Amber Canlas
• Kevin George Canlas, PA
• Theodore Martin Cannady
• Maxime Cannesson, MD
• Olivia Canning
• Anthony Cannizzaro, D.P.M.
• David Shefveland Cannom, M.D.
• Carissa Cannon
• Christina Lee Cannon, MA CCC-SLP
• David William Cannon, RD

• Dermatology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.