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Organization
GOOD SHEPHERD MEDICAL CLINIC, INC
Active
Organization
GOOD SHEPHERD MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC N BESHAY M.D. (PRESIDENT)
(714) 665-9890
Entity
Organization
Contact information
Practice address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Mailing address
661 W 1ST ST STE G, TUSTIN, CA 92780-2939
(714) 665-9890
(714) 665-9891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A89039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ67227Y
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/03/2011
Last updated
09/19/2011
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