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Individual

ANTHONY GANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2919 MISSION ST, SAN FRANCISCO, CA 94110-3917
(415) 229-0500
Mailing address
559 32ND ST, RICHMOND, CA 94804-1531
(347) 200-9179

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AGANNON
AGANNON
Enumeration date
07/12/2024
Last updated
07/12/2024
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