Cannon, Wayne Dilworth

Cannon, Wayne Dilworth is an individual health care provider with primary practice located at 1701 Divisadero St , San Francisco CA 94143-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Cannon, Wayne Dilworth can be contacted via phone (415) 353-7566.

Contact Information

Primary practice address
1701 Divisadero St San Francisco CA 94143-0001
Phone: (415) 353-7566
Fax: (415) 885-3862
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X G13165 California

Profile Details

NPI number 1538111992
LBN Legal business name Cannon, Wayne Dilworth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jul 9th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1538111992 NPPES
California MEDICAID 00G131650

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