Organization
CEP AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1201 PLEASANT VALLEY ROAD, OWENSBORO, KY 42303-9619
(270) 417-2000
Mailing address
2100 POWELL ST, STE 920, EMERYVILLE, CA 94608-1826
(510) 350-2698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/05/2011
Last updated
08/02/2013
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