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Organization

BIENESTAR MEDICAL CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MOHAMMAD WALID HASSAN BBS (ADMINISTRATOR)
(714) 285-1100
Entity
Organization

Contact information

Practice address
1125 E 17TH ST STE N152, SANTA ANA, CA 92701-2215
(714) 285-1100
Mailing address
1125 E 17TH ST STE N152, SANTA ANA, CA 92701-2215
(714) 285-1100

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
A61324
CA
174400000X
Specialist
A61671
CA
174400000X
Specialist
Primary
A81858
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A61324
CA
05
A61671
CA
05
A66267
CA
05
A81858
CA
Enumeration date
10/04/2007
Last updated
09/24/2013
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