Provider Demographics
NPI:1396582540
Name:PASSION FOR HEALING MEDICAL GROUP
Entity type:Organization
Organization Name:PASSION FOR HEALING MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:BESHAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-290-6269
Mailing Address - Street 1:2200 HARBOR BLVD STE B210
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5890
Mailing Address - Country:US
Mailing Address - Phone:949-548-2273
Mailing Address - Fax:949-548-4504
Practice Address - Street 1:2200 HARBOR BLVD STE B210
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5890
Practice Address - Country:US
Practice Address - Phone:949-548-2273
Practice Address - Fax:949-548-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty