Look up the most recent NPI and PECOS records

Cannon Medical Clinic Inc

Internal Medicine

Allopathic & Osteopathic Physicians

13000 N 103rd Ave #97, Sun City, AZ 85351-3060

PECOS Enrollment

Based on the most recent information from CMS, provider Cannon Medical Clinic Inc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1174876999
Provider Type
Organization
Full Name
Cannon Medical Clinic Inc

Subpart
No
Enumeration Date
10/17/2012
Last Updated
10/17/2012

Contact Information

Practice Location

13000 N 103rd Ave #97, Sun City, AZ 85351-3060

(623) 933-1337

(623) 933-6109

Mailing Location

13000 N 103rd Ave Ste 97, Sun City, AZ 85351-3060

(623) 933-1337

(623) 933-6109

Authorized Official

Cannon, George Lee (President)

(623) 933-1337

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License AZ4549 Arizona

Cannon Medical Clinic Inc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Patel, Harshana Rajul

Sun City Internal Medicine Pllc

Sandhu, Annumeet

Kuo, Jeffrey Alexander

Huxley, Angie K

Shah, Ashish

Rayani, Hamid H

Anita Dai Md Integrative Care Llc

Palnati, Srinivasa R

Avanihealthclinic Pc