Individual
LAURA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4341 PIEDMONT AVE STE 201, OAKLAND, CA 94611-4792
(510) 547-1630
Mailing address
4341 PIEDMONT AVE STE 201, OAKLAND, CA 94611-4792
(510) 547-1630
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT293972
CA
Other
Enumeration date
03/23/2018
Last updated
02/11/2022
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