Provider Demographics
NPI:1033463252
Name:MICHAEL S. CANN, M.D., INC.
Entity Type:Organization
Organization Name:MICHAEL S. CANN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STERLING
Authorized Official - Last Name:CANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-949-7380
Mailing Address - Street 1:1808 VERDUGO BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1477
Mailing Address - Country:US
Mailing Address - Phone:818-949-7380
Mailing Address - Fax:818-949-7384
Practice Address - Street 1:1808 VERDUGO BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1477
Practice Address - Country:US
Practice Address - Phone:818-949-7380
Practice Address - Fax:818-949-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23476207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty