Organization
CEP AMERICA - NEUROLOGY PC
Active
Other names
Vituity
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY MD (CHIEF EXECUTIVE OFFICER)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-1900
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
05/18/2017
Last updated
01/02/2020
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