California Emergency Physicians Medical Group, a Professional Corp
Organization Active NPI Internal Medicine Physician · San Diego, CA
NPI 1083070189 · NPPES record last updated Nov 16, 2016
Key facts
- NPI
- 1083070189
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP, A PROFESSIONAL CORP
- Practice address
- 1940 El Cajon Blvd
San Diego, CA 92104-1005 - Phone
- (619) 543-4500
- NPI assigned
- Jan 6, 2016
- Organization subpart
- No
Authorized official
- Name
- Theophile Koury, M.D
- Title
- President
- Phone
- (510) 350-2600
Other NPIs on the same Medicare enrollment 44
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140227000392 | CA | Part B Supplier - Clinic/Group Practice | 3274763875 |
Receives reassigned benefits from 141 practitioners 44 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Glendale, CA; Yuba City, CA; Truckee, CA; Sonora, CA; Millbrae, CA; Los Gatos, CA; Laguna Hills, CA; Fountain Valley, CA… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
1940 El Cajon Blvd
San Diego, CA 92104-1005
Mailing address
2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600
Other providers in San Diego, CA
- California Care Wellness Medical Center Inc.
- California Children Services
- California Coast Cardiovascular, PC
- California Department of Health Care Services
- California Emergency Physc Med GRP
- California Emergency Physicians Medical Group, a Professional Corporat
- California Eye Prosthetics, Inc
- California Fertility Experts
- California Institute of Plastic and Reconstructive Surgery a Med. Corp
- California Ocd and Anxiety Psychologists, Professional Corporation
All providers in San Diego, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.