Provider Demographics
NPI:1790172260
Name:CEP AMERICA - KANSAS LLC
Entity Type:Organization
Organization Name:CEP AMERICA - KANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEOPHILE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-350-2600
Mailing Address - Street 1:1601 CUMMINS DR STE D
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-6411
Mailing Address - Country:US
Mailing Address - Phone:510-350-2600
Mailing Address - Fax:
Practice Address - Street 1:14800 W SAINT TERESA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235-9602
Practice Address - Country:US
Practice Address - Phone:316-268-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty