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General NPI Number Information
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NPI Number | 1528097045
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Entity Type | Individual
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Provider Name | ROBERT JAMES CANNON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 3865 JACKSON ST
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City | RIVERSIDE
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State | CA
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Zip | 92503-3919
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Country | US
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Telephone | 951-352-5666
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Fax | 951-352-5445
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Provider Business Mailing Address
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Address Line | 11 STONEGATE
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City | IRVINE
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State | CA
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Zip | 92602-2451
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Country | US
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Telephone | 949-734-3363
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Fax | 949-294-1404
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A39500
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License Number State | CA
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