| Good Shepherd Medical Clinic, Inc | |
|
661 W 1st St Ste G Tustin CA 92780-2939 | |
| (714) 665-9890 | |
| (714) 665-9891 |
| Full Name | Good Shepherd Medical Clinic, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 661 W 1st St Ste G, Tustin, California |
| Authorized Official Name and Position | Isaac N Beshay (PRESIDENT) |
| Authorized Official Contact | 7146659890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Medical Clinic, Inc 661 W 1st St Ste G Tustin CA 92780-2939 Ph: (714) 665-9890 | Good Shepherd Medical Clinic, Inc 661 W 1st St Ste G Tustin CA 92780-2939 Ph: (714) 665-9890 |
| NPI Number | 1427336791 |
|---|---|
| Provider Enumeration Date | 08/03/2011 |
| Last Update Date | 09/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427336791 | NPI | - | NPPES |
| ZZZ67227Y | Other | CA | BLUE SHIELD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A89039 (California) | Primary |
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