Organization
CEP AMERICA LLC
Active
Other names
Vituity
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BIRDSALL MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 673-0611
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2600
(510) 879-9100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202432
WASHINGTON L&I
—
05
—
276322
—
OR
01
—
38D0957800
CLIA WAIVER
—
05
—
7128564
—
WA
01
—
858543000
REGENCE BC/BS OF OR
OR
01
—
DD5040
RAILROAD MEDICARE
—
Enumeration date
04/10/2006
Last updated
04/01/2020
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