Organization
CEP AMERICA - CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
600 N. HIGHLAND SPRINGS AVENUE, BANNING, CA 92220-3090
(951) 845-1121
Mailing address
2100 POWELL STREET, STE. 920, EMERYVILLE, CA 94608-1803
(510) 350-2777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0013023
—
CA
Enumeration date
05/23/2006
Last updated
05/11/2016
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