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General NPI Number Information
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NPI Number | 1336948629
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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 | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1915 LAKE AVE
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City | PLYMOUTH
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State | IN
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Zip | 46563-9366
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Country | US
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Telephone | 574-948-4000
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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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