Provider Demographics
NPI:1821335274
Name:STEPHEN W MCCANN MD INC
Entity Type:Organization
Organization Name:STEPHEN W MCCANN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-540-2282
Mailing Address - Street 1:23456 HAWTHORNE BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4716
Mailing Address - Country:US
Mailing Address - Phone:310-540-2282
Mailing Address - Fax:310-316-2876
Practice Address - Street 1:23456 HAWTHORNE BLVD STE 260
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4716
Practice Address - Country:US
Practice Address - Phone:310-540-2282
Practice Address - Fax:310-316-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30102207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty