# CALIFORNIA EMERGENCY PHYSICIAN MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962791293
- **Authorized official:** DR. THEOPHILE KOURY MD (COO)
- **Authorized official phone:** (510) 350-2600

## Contact information

- **Practice address:** 1601 YGNACIO VALLEY RD, WALNUT CREEK, CA 94598-3122
- **Practice address phone:** (925) 947-5399
- **Mailing address:** 2100 POWELL ST STE 900, EMERYVILLE, CA 94608-1844
- **Mailing address phone:** (510) 350-2600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2011
- **Last updated:** 08/19/2013