NPIMap

Organization Active NPI

California Emergency Physicians Medical Group, a Professional Corp.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Glendale, CA
National Provider Identifier
1881315091
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP, A PROFESSIONAL CORP.
Practice address
1560 E Chevy Chase Dr Ste 355
Glendale, CA 91206-4159
Phone
(747) 212-3441
NPI assigned
Sep 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Theophile G. Koury, MD
Title
MD, President
Phone
(510) 350-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

1560 E Chevy Chase Dr Ste 355
Glendale, CA 91206-4159

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411

Other practice location 1

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

Other practice location 2

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6229

Other names 1

  • Vituity Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 44

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 44

National Provider Directory

National Provider Directory
Tax ID family
California Emergency Physicians Medical Group a Professional Corp20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

2975 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 522-2500

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1881315091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E CHEVY CHASE DR STE 355",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064159",
            "telephone_number": "747-212-3441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 Wilson Ter",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912064007",
            "country_code": "US",
            "telephone_number": "818-409-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2975 Sycamore Dr",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930651201",
            "country_code": "US",
            "telephone_number": "805-955-6229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP, A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MD, PRESIDENT",
        "authorized_official_telephone_number": "510-350-2774",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vituity",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vituity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.