Provider Demographics
NPI:1942217500
Name:MCCANN, NORMAN D (MD)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:D
Last Name:MCCANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 PALMETTO AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
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:STE 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-891-4811
Practice Address - Fax:530-891-1743
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G159070207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
A39657Medicare UPIN
00G159070Medicare ID - Type Unspecified