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NPI Code Detail

MEDICARE: CEP AMERICA LLC

MEDICARE: CEP AMERICA LLC
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

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5DD5040OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2202432OTHERWASHINGTON L&I
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4858543000OTHERORREGENCE BC/BS OF OR
638D0957800OTHERCLIA WAIVER

General Provider Information

NPI Number : 1780647719
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEP AMERICA LLC
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 : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1281
Country : US
Telephone Number : 541-673-0611
Fax Number :
Authorized Official
Title or Position : COO
Name : DR. DAVID BIRDSALL
Credential : MD
Telephone Number : 510-350-2600
Provider Enumeration Date : 04/10/2006
Last Update Date : 04/01/2020

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Directions to “CEP AMERICA LLC ” Practice Location

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