Organization
CALIFORNIA EMERGENCY PHYSC MED GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
26137 LA PAZ RD, SUITE 120, MISSION VIEJO, CA 92691-5319
(510) 350-2663
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/27/2008
Last updated
08/29/2013
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