Provider Demographics
NPI:1285795773
Name:GOOD SAMARITAN MEDICAL CLINIC, INC
Entity type:Organization
Organization Name:GOOD SAMARITAN MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:NAGEIB
Authorized Official - Last Name:BESHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-774-7500
Mailing Address - Street 1:801 N HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1810
Mailing Address - Country:US
Mailing Address - Phone:714-774-7500
Mailing Address - Fax:714-774-7502
Practice Address - Street 1:801 N HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1810
Practice Address - Country:US
Practice Address - Phone:714-774-7500
Practice Address - Fax:714-774-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty