Cannon, Derrick
Cannon, Derrick is an sole proprietor health care provider with primary practice located at 820 E Gilbert St , San Bernardino CA 92415-1403. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Cannon, Derrick can be contacted via phone (909) 388-5644.Contact Information
Primary practice address
820 E Gilbert St
San Bernardino CA 92415-1403
Phone: (909) 388-5644
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
NPI number | 1063057149 |
---|---|
LBN Legal business name | Cannon, Derrick |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 12th, 2019 |
Last updated | Nov 26th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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