Organization
CEP AMERICA - KANSAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE G. KOURY MD (PRESIDENT)
(510) 350-2600
Entity
Organization
Contact information
Practice address
3251 N ROCK RD, DERBY, KS 67037-3850
(833) 345-7625
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
—
—
Other
Enumeration date
01/25/2019
Last updated
07/20/2023
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