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Organization

GOOD SHEPHARD MEDICAL CLINIC

Active
Parent organization
BANJ HEALTH CENTER, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANJ HEALTH CENTER, INC.
Authorized official
MRS. MARIE NERLANDE LAMOTHE (EXECUTIVE DIRECTOR)
(310) 635-7123
Entity
Organization

Contact information

Practice address
661 W 1RST STREEET # G, TUSTIN, CA 92780
(714) 665-9890
(714) 665-9891
Mailing address
201 N CENTRAL AVE, COMPTON, CA 90220-1425
(310) 635-7123
(310) 635-0535

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QF0050X
Non-Surgical Family Planning Clinic/Center
960001116
CA
261QM0850X
Adult Mental Health Clinic/Center

Other

Enumeration date
04/26/2013
Last updated
04/26/2013
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