NPIMap

Organization Active NPI

Patrick J. Cannon, MD Facs a Medical Corporation

  • Urology Physician
  • Encino, CA
National Provider Identifier
1740590983
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G29054 Issued in CA
Legal business name
PATRICK J. CANNON, MD FACS A MEDICAL CORPORATION
Practice address
16101 Ventura Blvd
Suite 300
Encino, CA 91436-2500
Phone
(818) 788-5700
Fax
(818) 788-5702
NPI assigned
Oct 20, 2010
Last updated
Apr 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Patrick James Cannon, MDNPI 1689738262
Title
President
Phone
(818) 788-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X G29054 CA Primary

Addresses

Primary practice location

16101 Ventura Blvd
Suite 300
Encino, CA 91436-2500

Mailing address

16101 Ventura Blvd
Suite 300
Encino, CA 91436-2500
Phone (818) 788-5700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1740590983",
    "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": {
        "organization_name": "PATRICK J. CANNON, MD FACS A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-788-5700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G29054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.