Organization
CALIFORNIA EMERGENCY PHYSC MED GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY (M.D)
(510) 350-2600
Entity
Organization
Contact information
Practice address
219 NORTH JACKSON AVENUE, SAN JOSE, CA 95116
(408) 729-2841
Mailing address
2100 POWELL STREET, STE 900, EMERYVILLE, CA 94608-1844
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/08/2006
Last updated
11/12/2014
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