MEDICARE: CEP AMERICA - CALIFORNIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306899166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEP AMERICA - CALIFORNIA

Provider Business Mailing Address
First Line	:	1601 CUMMINS DR STE D
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95358-6411
Country	:	US
Telephone Number	:	510-350-2600
Fax Number	:	510-879-9100

Provider Business Practice Location Address
First Line	:	400 NORTH PEPPER AVENUE
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-1819
Country	:	US
Telephone Number	:	909-580-1400
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	DAVID BIRDSALL
Credential	:	MD
Telephone Number	:	510-350-2600

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	03/19/2020

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Directions to “CEP AMERICA - CALIFORNIA ” Practice Location

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