Good Samaritan Community Health Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

GOOD SAMARITAN COMMUNITY HEALTH CENTER

Practice address

482 Corona Mall
Corona, CA 92879-1418

Phone

(951) 642-2974

NPI assigned

Aug 12, 2022

Organization subpart

No

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

Authorized official

Name

Mowbray Hagan, MD

Title

Ceo

Phone

(951) 642-2974

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1639807985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 CORONA MALL",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928791418",
            "telephone_number": "951-642-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "HAGAN",
        "authorized_official_first_name": "MOWBRAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-642-2974",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gonzalez
• Nayeli Gonzalez
• Nichole Gonzalez
• Tiffany Gonzalez
• Yolanda Gonzalez, PPS
• Good Samaritan Hospice LLC
• Michael Thomas Goode, OTR/L
• David Lee Gooding Jr., RBT
• Michael Paul Gordon, RCP-RRT
• Elyssa Noel Gorham

• Community Health Clinic/Center in Corona, CA
• Providers in Corona, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.