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
3300 RENNER DR, FORTUNA, CA 95540-3120
(707) 725-3361
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
08/11/2010
Last updated
05/11/2016
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