MEDICARE: CEP AMERICA - ANESTHESIA PC

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1902375199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEP AMERICA - ANESTHESIA PC

Provider Business Mailing Address
First Line	:	2100 POWELL ST STE 900
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-1844
Country	:	US
Telephone Number	:	510-350-2680
Fax Number	:

Provider Business Practice Location Address
First Line	:	18653 WEDGE PKWY STE 170
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-3037
Country	:	US
Telephone Number	:	775-674-5200
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAVID BIRDSALL
Credential	:	MD
Telephone Number	:	510-350-2680

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	11/16/2018

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Directions to “CEP AMERICA - ANESTHESIA PC ” Practice Location

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