Organization
CALIFORNIA EMERGENCY PHYSICIAN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY MD (COO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1601 YGNACIO VALLEY RD, WALNUT CREEK, CA 94598-3122
(925) 947-5399
Mailing address
2100 POWELL ST STE 900, EMERYVILLE, CA 94608-1844
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/07/2011
Last updated
08/19/2013
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