Terracina Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A65841 Issued in CA

Legal business name

TERRACINA MEDICAL CLINIC INC

Practice address

34636 County Line Rd
Suite 32
Yucaipa, CA 92399-5393

Phone

(909) 795-9355

Fax

(909) 795-9439

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maged G Samaan, DONPI 1508856543

Title

Owner

Phone

(909) 795-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maged Samaan, DO

  • Family Medicine Physician
  • Yucapa, CA
  • NPI 1508856543
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1336356690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34636 COUNTY LINE RD STE 32",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995393",
            "telephone_number": "909-795-9355",
            "fax_number": "909-795-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34636 COUNTY LINE RD",
            "address_2": "SUITE 32",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995393",
            "telephone_number": "909-795-9355",
            "fax_number": "909-795-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRACINA MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "SAMAAN",
        "authorized_official_first_name": "MAGED",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-795-9355",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX65840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Eugene Taylor III, PA-C
• Cecil Templeton
• Jacob Brian Templin
• Rachael Suzanne Tennant, MD
• Oxana Teppone-Martin, CRNA
• Terry'S Helping Hands Service
• The Well Outreach Centr
• Angelica Theron
• Alana Love Thompson
• Salan So Thong, PHARMD.

• Family Medicine Physician in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.