Individual
JOHN JACOB CANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 MARSH ST STE 203, SAN LUIS OBISPO, CA 93401-2968
(805) 439-2569
(805) 439-1073
Mailing address
1411 MARSH ST STE 203, SAN LUIS OBISPO, CA 93401-2968
(805) 439-2569
(805) 439-1073
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C37547
CA
Other
Enumeration date
05/16/2006
Last updated
01/17/2014
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