TERRACINA MEDICAL CLINIC INC NPI 1336356690

NPI Information

NPI: 1336356690
Provider Name: TERRACINA MEDICAL CLINIC INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
34636 COUNTY LINE RD
SUITE 32
YUCAIPA, CA
ZIP 92399
Phone: (909) 795-9355
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TERRACINA MEDICAL CLINIC INC is a family medicine in Yucaipa, CA. The provider is 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. TERRACINA MEDICAL CLINIC INC NPI is 1336356690. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

34636 COUNTY LINE RD
SUITE 32
YUCAIPA, CA
ZIP 92399-393
Phone: (909) 795-9355
Fax: (909) 795-9439

The provider's authorized official is Maged G Samaan .
The authorized official title is Owner and has the following contact phone number (909) 795-9355.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		A65841	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00AX65840	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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