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General NPI Number Information
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NPI Number | 1164535381
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 23962 ALICIA PKWY STE 1
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3940
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Country | US
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Telephone | 949-452-7699
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 POWELL ST STE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1826
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Country | US
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Telephone | 510-350-2600
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DR. THEOPHILE KOURY
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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