Organization
CEP AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0800
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/27/2023
Last updated
06/13/2024
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