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Organization
GOOD SHEPHERD PHYSICIAN ASSISTANT CORPORATION
Active
Organization
GOOD SHEPHERD PHYSICIAN ASSISTANT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMGAD ALFRED PA (PRESIDENT)
(909) 480-4808
Entity
Organization
Contact information
Practice address
8283 GROVE AVE STE 102, RANCHO CUCAMONGA, CA 91730-3138
(909) 480-4808
(909) 480-4843
Mailing address
12872 SILVER ROSE CT, RANCHO CUCAMONGA, CA 91739-8842
(909) 480-4808
(909) 480-4843
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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