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NPI 1154125698

NPI 1154125698 : CEP AMERICA LLC : GOSHEN, IN

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General NPI Number Information
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    NPI Number           |    1154125698
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    Entity Type          |    Organization 
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    Legal Business Name  |    CEP AMERICA LLC 
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Dates
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    Enumeration Date     |    04/03/2025
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    Last Update Date     |    04/03/2025
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Provider Practice Location Address
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    Address Line         |    200 HIGH PARK AVE 
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    City                 |    GOSHEN
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    State                |    IN
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    Zip                  |    46526-4810
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    Country              |    US
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    Telephone            |    574-364-2608
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2100 POWELL ST STE 400 
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    City                 |    EMERYVILLE
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    State                |    CA
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    Zip                  |    94608-1872
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    Country              |    US
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    Telephone            |    510-851-7501
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    Fax                  |    
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Authorized Official
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    Title or Position    |    COO OF CLINICAL OPERATIONS
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    Name                 |     DAVID  BIRDSALL 
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    Credential           |    MD
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    Telephone            |    510-350-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    
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    License Number State |    
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