Individual
JOHN CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 S AMPHLETT BLVD STE 200, SAN MATEO, CA 94402-2717
(650) 685-6558
(650) 240-8669
Mailing address
1700 S AMPHLETT BLVD STE 200, SAN MATEO, CA 94402-2717
(650) 685-6558
(650) 240-8669
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
47-2097352
CA
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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