California Emergency Physc Med GRP

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CALIFORNIA EMERGENCY PHYSC MED GRP

Practice address

219 North Jackson Avenue
San Jose, CA 95116

Phone

(408) 729-2841

NPI assigned

Jun 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Theophile Koury

Title

M.D

Phone

(510) 350-2600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1720028574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 NORTH JACKSON AVENUE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95116",
            "telephone_number": "408-729-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA EMERGENCY PHYSC MED GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarissa Caliboso
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• California Emergency Physicians Medical Group, a Professional Corp

• Emergency Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.