MEDICARE: CALIFORNIA EMERGENCY PHYSICIANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		CA

General Provider Information

NPI Number	:	1780109611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA EMERGENCY PHYSICIANS

Provider Business Mailing Address
First Line	:	1601 CUMMINS DR STE D
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95358-6411
Country	:	US
Telephone Number	:	510-851-7423
Fax Number	:

Provider Business Practice Location Address
First Line	:	2048 LINCOLN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-3449
Country	:	US
Telephone Number	:	408-448-1677
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAVID ANDREW BIRDSALL
Credential	:	MD
Telephone Number	:	510-350-2600

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	01/13/2020

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