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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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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