Organization
CEP AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL M.D (C.O.O)
(510) 350-2600
Entity
Organization
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-5200
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2638
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
04/01/2020
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