Healthcare Provider Details
I. General information
NPI: 1861316788
Provider Name (Legal Business Name): CEP AMERICA - NEUROLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 N HIGHLAND SPRINGS AVE
BANNING CA
92220-3046
US
IV. Provider business mailing address
1601 CUMMINS DR STE D
MODESTO CA
95358-6411
US
V. Phone/Fax
- Phone: 951-845-1121
- Fax:
- Phone: 510-851-7501
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
BIRDSALL
Title or Position: VP AND SECRETARY
Credential: MD
Phone: 510-350-2600