| Terracina Medical Clinic Inc | |
|
34636 County Line Rd Suite 32 Yucaipa CA 92399-5393 | |
| (909) 795-9355 | |
| (909) 795-9439 |
| Full Name | Terracina Medical Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 34636 County Line Rd, Yucaipa, California |
| Authorized Official Name and Position | Maged G Samaan (OWNER) |
| Authorized Official Contact | 9097959355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terracina Medical Clinic Inc 34636 County Line Rd Ste 32 Yucaipa CA 92399-5393 Ph: (909) 795-9355 | Terracina Medical Clinic Inc 34636 County Line Rd Suite 32 Yucaipa CA 92399-5393 Ph: (909) 795-9355 |
| NPI Number | 1336356690 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 10/31/2023 |
| Medicare PECOS PAC ID | 0446154280 |
|---|---|
| Medicare Enrollment ID | O20031122000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336356690 | NPI | - | NPPES |
| 00AX65840 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A65841 (California) | Primary |
| Provider Name | Maged G Samaan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508856543 PECOS PAC ID: 0941104707 Enrollment ID: I20120209000314 |
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