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Individual
MICHAEL L MCGANNON
Active
Individual
MICHAEL L MCGANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C32614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235216755
—
CA
01
—
C32614
ANTHEM BLUE CROSS
CA
Enumeration date
11/01/2006
Last updated
03/11/2009
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