| Good Shepherd Md Prof Inc | |
|
8283 Grove Ave Ste 102 Rancho Cucamonga CA 91730-3138 | |
| (909) 480-4808 | |
| (909) 480-4843 |
| Full Name | Good Shepherd Md Prof Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 8283 Grove Ave Ste 102, Rancho Cucamonga, California |
| Authorized Official Name and Position | Amin Abdelmeseeh (PRESIDENT) |
| Authorized Official Contact | 9094804808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Md Prof Inc 8283 Grove Ave Ste 102 Rancho Cucamonga CA 91730-3138 Ph: (909) 480-4808 | Good Shepherd Md Prof Inc 8283 Grove Ave Ste 102 Rancho Cucamonga CA 91730-3138 Ph: (909) 480-4808 |
| NPI Number | 1336839273 |
|---|---|
| Provider Enumeration Date | 05/12/2023 |
| Last Update Date | 05/26/2023 |
| Medicare PECOS PAC ID | 6800245952 |
|---|---|
| Medicare Enrollment ID | O20231214000760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336839273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amin S Abdelmeseeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699823518 PECOS PAC ID: 9133290034 Enrollment ID: I20080620000183 |
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