Healthcare Provider Details

I. General information

NPI: 1235842196
Provider Name (Legal Business Name): CEP AMERICA - ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 NW STEWART PKWY
ROSEBURG OR
97471-1281
US

IV. Provider business mailing address

2100 POWELL ST STE 400
EMERYVILLE CA
94608-1872
US

V. Phone/Fax

Practice location:
  • Phone: 541-673-0611
  • Fax:
Mailing address:
  • Phone: 510-350-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID BIRDSALL
Title or Position: V.P./SECRETARY
Credential: M.D.
Phone: 510-350-2600