Organization
GOOD SHEPHERD HEALTHCARE LLC
Active
Other names
Medical Imaging and Intervention, Good Shepherd Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EMEEL MOUSA MD (FOUNDER/OWNER)
(714) 801-8878
Entity
Organization
Contact information
Practice address
9395 MAGNOLIA AVE, RIVERSIDE, CA 92503-3747
(714) 801-8878
Mailing address
11199 TESOTA LOOP ST, CORONA, CA 92883-3059
(714) 801-8878
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Enumeration date
12/24/2018
Last updated
03/15/2021
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