Healthcare Provider Details

I. General information

NPI: 1124131321
Provider Name (Legal Business Name): MICHAEL STERLING CANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 VERDUGO BLVD 112
GLENDALE CA
91208-1477
US

IV. Provider business mailing address

1808 VERDUGO BLVD 112
GLENDALE CA
91208-1477
US

V. Phone/Fax

Practice location:
  • Phone: 818-949-7380
  • Fax: 818-949-7384
Mailing address:
  • Phone: 818-949-7380
  • Fax: 818-949-7384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG23476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: