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NPI Code Detail

MEDICARE: CEP AMERICA - CALIFORNIA

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
1207P00000XEmergency Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1619926771
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 : 510-350-2770
Fax Number :
Provider Business Practice Location Address
First Line : 350 TERRACINA BLVD
Second Line :
City : REDLANDS
State : CA
Zip : 92373-4850
Country : US
Telephone Number : 909-335-6449
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATIONS OFFICER
Name : DAVID BIRDSALL
Credential : MD
Telephone Number : 510-350-2600
Provider Enumeration Date : 05/08/2006
Last Update Date : 03/24/2020

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Directions to “CEP AMERICA - CALIFORNIA ” Practice Location

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