| Good Samaritan Medical Clinic, Inc | |
|
801 N Harbor Blvd Anaheim CA 92805-1810 | |
| (714) 774-7500 | |
| (714) 774-7502 |
| Full Name | Good Samaritan Medical Clinic, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 801 N Harbor Blvd, Anaheim, California |
| Authorized Official Name and Position | Youssef Nageib Beshai (CEO, MEDICAL DOCTOR) |
| Authorized Official Contact | 7147747500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Medical Clinic, Inc 801 N Harbor Blvd Anaheim CA 92805-1810 Ph: (714) 774-7500 | Good Samaritan Medical Clinic, Inc 801 N Harbor Blvd Anaheim CA 92805-1810 Ph: (714) 774-7500 |
| NPI Number | 1285795773 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/10/2011 |
| Medicare PECOS PAC ID | 6709798093 |
|---|---|
| Medicare Enrollment ID | O20031104000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285795773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Youssef Nageib Beshai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265465926 PECOS PAC ID: 7517879810 Enrollment ID: I20031112000459 |
| Provider Name | Cristina T Hamdja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669991014 PECOS PAC ID: 9032542683 Enrollment ID: I20191212000837 |
| Provider Name | Michael Jay Boling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124295134 PECOS PAC ID: 0547679052 Enrollment ID: I20210513002608 |
| Provider Name | Lori Kortkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083249353 PECOS PAC ID: 7012314115 Enrollment ID: I20210915003857 |
| Provider Name | Patti Jean Pickler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275018210 PECOS PAC ID: 3072902105 Enrollment ID: I20211111001410 |
| Provider Name | Hannah Lynn Petrenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457027211 PECOS PAC ID: 9638547524 Enrollment ID: I20221128000949 |
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