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General NPI Number Information
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NPI Number | 1205939659
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Entity Type | Individual
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Provider Name | ROBERT NELSON CANN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1070 E GREEN ST SUITE 200
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City | PASADENA
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State | CA
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Zip | 91106-2432
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Country | US
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Telephone | 626-568-8184
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Fax | 626-405-0641
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Provider Business Mailing Address
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Address Line | PO BOX 50290
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City | PASADENA
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State | CA
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Zip | 91115
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Country | US
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Telephone | 626-568-8184
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Fax | 626-405-0641
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G45579
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License Number State | CA
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