| Cep America - Neurology Pc | |
|
250 S Grand Ave Glendora CA 91741-4218 | |
| (626) 963-8411 | |
| Not Available |
| Full Name | Cep America - Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 250 S Grand Ave, Glendora, California |
| Authorized Official Name and Position | Theophile G. Koury (CEO) |
| Authorized Official Contact | 5103502600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cep America - Neurology Pc 1601 Cummins Dr Ste D Modesto CA 95358-6411 Ph: (510) 350-2644 | Cep America - Neurology Pc 250 S Grand Ave Glendora CA 91741-4218 Ph: (626) 963-8411 |
| NPI Number | 1679085427 |
|---|---|
| Provider Enumeration Date | 11/02/2017 |
| Last Update Date | 01/02/2020 |
| Certification Date | 01/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679085427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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