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NPI Code Detail

MEDICARE: CEP AMERICA - KANSAS LLC

MEDICARE: CEP AMERICA - KANSAS 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

General Provider Information

NPI Number : 1790172260
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEP AMERICA - KANSAS 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 :
Provider Business Practice Location Address
First Line : 14800 W SAINT TERESA ST
Second Line :
City : WICHITA
State : KS
Zip : 67235-9602
Country : US
Telephone Number : 316-268-7000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. THEOPHILE KOURY
Credential :
Telephone Number : 510-350-2600
Provider Enumeration Date : 04/22/2015
Last Update Date : 07/20/2023

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Directions to “CEP AMERICA - KANSAS LLC ” Practice Location

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