Organization Active NPI

Cep America - California

  • Emergency Medicine Physician
  • Banning, CA
National Provider Identifier
1750336269
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEP AMERICA - CALIFORNIA
Practice address
600 N. Highland Springs Avenue
Banning, CA 92220-3090
Phone
(951) 845-1121
NPI assigned
May 23, 2006
Last updated
May 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Dr. Theophile Koury, MDNPI 1568483691
Title
Coo
Phone
(510) 350-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

600 N. Highland Springs Avenue
Banning, CA 92220-3090

Mailing address

2100 Powell Street
Ste. 920
Emeryville, CA 94608-1803
Phone (510) 350-2777

Other identifiers 1

IdentifierTypeStateIssuer
GR0013023MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000520 CA Part B Supplier - Clinic/Group Practice 6103739131 Receives reassigned benefits from 3,525 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1750336269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE. 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N. HIGHLAND SPRINGS AVENUE",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203090",
            "telephone_number": "951-845-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA - CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0013023",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.