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Organization

CEP AMERICA - ILLINOIS SNF, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID BIRDSALL MD (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2680
Entity
Organization

Contact information

Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 288-5711
Mailing address
2100 POWELL ST, EMERYVILLE, CA 94608-1826
(510) 350-2680

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Enumeration date
10/24/2017
Last updated
10/24/2017
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