Tucker Croxall Cannon in Newport Beach - Clinical
Tucker Croxall Cannon - NPI 1205969623
Tucker Croxall Cannon is a Clinical in Newport Beach, California. Tucker Croxall Cannon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Tucker Croxall Cannon is 1205969623. The last update date is 2012-11-02.
Tucker Croxall Cannon's current location address is 204 Main St. Suite 4091, Newport Beach, California. You can contact this provider via phone number 9492449982. The mailing address for Tucker Croxall Cannon is 204 Main St. Suite 4091, Newport Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tucker Croxall Cannon |
|---|---|
| Address | 204 Main St. Suite 4091, Newport Beach, California |
| Phone Number | 9492449982 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1205969623 |
|---|---|
| Provider Enumeration Date | 2007-03-14 |
| Last Updated Date | 2012-11-02 |
Provider Mailing Address Detail
| Address | 204 Main St. Suite 4091 |
|---|---|
| City | Newport Beach |
| State | California (CA) |
| Post Code | 926619998 |
| Phone Number | 9492449982 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 28707 |
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What is the unique identifier code issued to Tucker Croxall Cannon by the Centers for Medicare & Medicaid Services?
The Tucker Croxall Cannon has been assigned the NPI (National Provider Identifier) 1205969623. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Tucker Croxall Cannon is physically located?
The Tucker Croxall Cannon is physically situated at the following address: 204 Main St. Suite 4091, Newport Beach, CA, 926619998.
What is Tucker Croxall Cannon's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Tucker Croxall Cannon's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1205969623 to Tucker Croxall Cannon?
The Centers for Medicare & Medicaid Services assigned the 1205969623 to Tucker Croxall Cannon on 2007-03-14.
As of what date were the details related to Tucker Croxall Cannon most recently updated or revised?
The information pertaining to Tucker Croxall Cannon, including its address, specialty, and other relevant details, was last updated or revised on 2012-11-02.