Organization
SAINT YOUSTINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC BESHAY MD (CEO/CMO)
(714) 290-6269
Entity
Organization
Contact information
Practice address
2200 HARBOR BLVD STE B240, COSTA MESA, CA 92627-5875
(714) 290-6269
Mailing address
2200 HARBOR BLVD STE 240, COSTA MESA, CA 92627-2501
(714) 290-6269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4360542
—
CA
Enumeration date
10/28/2022
Last updated
10/28/2022
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