Provider Demographics
NPI:1588023949
Name:CEP AMERICA - ANESTHESIA PC
Entity Type:Organization
Organization Name:CEP AMERICA - ANESTHESIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:THEOPHILE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-350-2600
Mailing Address - Street 1:PO BOX 45741
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 WELCH RD
Practice Address - Street 2:300
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1805
Practice Address - Country:US
Practice Address - Phone:650-325-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty