Provider Demographics
NPI:1093022659
Name:NORMAN D MCCANN MD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:NORMAN D MCCANN MD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-891-4811
Mailing Address - Street 1:669 PALMETTO AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-4080
Mailing Address - Country:US
Mailing Address - Phone:530-891-4811
Mailing Address - Fax:530-891-1743
Practice Address - Street 1:669 PALMETTO AVE
Practice Address - Street 2:SUITE I
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-4080
Practice Address - Country:US
Practice Address - Phone:530-891-4811
Practice Address - Fax:530-891-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15907174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG15907OtherPHYSICIAN AND SURGEON LICENSE
CA00G159070Medicaid
CAA39657Medicare UPIN