Patrick J Cannon, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G29054 Issued in CA

Practice address

16101 Ventura Blvd
Suite 300
Encino, CA 91436-2500

Phone

(818) 788-5700

Fax

(818) 788-5702

NPI assigned

Dec 20, 2006

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689738262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD",
            "address_2": "SUITE 300",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362500",
            "telephone_number": "818-788-5700",
            "fax_number": "818-788-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD",
            "address_2": "SUITE 300",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362500",
            "telephone_number": "818-788-5700",
            "fax_number": "818-788-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G29054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Faith Copon Campano
• Ricardo Campbell, P.A.
• Arturo Nieto Campos
• Felipe Juaquin Campos Jr., BCBA
• Candice Sherbin MFT, Inc.
• Viviana Cano
• Jamie Lynn Cantor, MA MFT
• Erin Cantwell, PHD
• Canyon West Los Angeles LLC
• Jessica Lely Cao

• Urology Physician in Encino, CA
• Providers in Encino, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.