GOOD SHEPHERD MEDICAL CLINIC, INC (NPI# 1427336791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427336791 |
| Entity Type | Organization |
| Organization Name | GOOD SHEPHERD MEDICAL CLINIC, INC |
| Practice Address |
661 W 1st St Ste G Tustin CA 92780-2939 |
| Practice Telephone | 7146659890 |
| Practice Fax Number | 7146659891 |
| Mailing Telephone | 7146659890 |
| Mailing Fax Number | 7146659891 |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-09-19 |
| Authorized Official Name | DR. ISAAC N BESHAY (PRESIDENT) |
| Authorized Official Telephone | 7146659890 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A89039 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CALIFORNIA | ZZZ67227Y | 01 |
| Street Address |
661 W 1ST ST STE G |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780-2939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952932675 | Diana Fajardo-salcedo | Social Worker | 661 W 1st St Ste G, Tustin, CA 92780-2939 | 2020-01-31 |
| 1023648623 | Families Together of Orange County | Clinic/Center | 661 W 1st St Ste G, Tustin, CA 92780-2939 | 2020-01-22 |
| 1053880567 | Tiffany Chau Estera | Nurse Practitioner | 661 W 1st St Ste G, Tustin, CA 92780 | 2018-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
| 1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
| 1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
| 1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
| 1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
| 1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
| 1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
| 1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
| Find all providers in zip 92780 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275153389 | Innovi Healthcare Inc. | Family Medicine | 11220 Amberdale Dr, Tustin, CA 92782-4329 | 2020-04-18 |
| 1669822284 | Carrie Jasmine Lam | Family Medicine | 2492 Walnut Ave Ste 100, Tustin, CA 92780-6953 | 2016-06-14 |
| 1669859203 | Todd Macauley | Family Medicine | 2560 Bryan Ave Ste A, Tustin, CA 92782-8922 | 2015-05-04 |
| 1457566036 | Shadia Ahmed | Family Medicine | 16634 Sonora St, Tustin, CA 92782-1938 | 2007-05-14 |
| 1619064953 | Tahany Maurice Habashy | Family Medicine | 222 West Main St, Suite 102, Tustin, CA 92780-7711 | 2006-10-06 |
| 1760594790 | Anthony F Naples | Family Medicine | 13095 Jamboree Rd, Tustin, CA 92782-9150 | 2006-08-31 |
| 1760594097 | Simon Y. Chang | Family Medicine | 13522 Newport Ave, Suite 102, Tustin, CA 92780-3707 | 2006-08-31 |
| 1992760573 | Cheryl Ann Thomas | Family Medicine | 195 S C St, Ste 100, Tustin, CA 92780-3666 | 2006-04-18 |
| 1578523502 | Jonathan Andrew Dennis | Family Medicine | 111 Church Street, Tustin, MI 49688-5113 | 2006-03-24 |
| 1366401580 | Susan M Sharp | Family Medicine | 17400 Irvine Blvd M, Tustin, CA 92780-3030 | 2006-03-17 |
| Find all providers in TUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.