2022-09-13T11:56:54-05:00 2021-12-31 942702860 JOHANSON & YAU ACCOUNTANCY CORP 42 WEST CAMPBELL AVENUE THIRD FLOOR CAMPBELL CA 95008 990 2021-01-01 912146048 MEDICAL STAFF OF GOOD SAMARITAN HOSPITAL MEDI 4085592388 2425 SAMARITAN DRIVE SAN JOSE CA 951243809 JANE YIEH TREASURER 4085592388 2022-06-17 1 JANE YIEH 999009999 MICHAEL LIN P01353244 4082885111 2022-06-15 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JANE YIEH 2425 SAMARITAN DRIVE SAN JOSE CA 951243809 299478 0 X N/A X CA THE ORGANIZATION IS DEDICATED TO THE TASK OF PROMOTING HIGH QUALITY MEDICAL CARE FOR ALL PATIENTS ADMITTED TO OR TREATED IN THE HOSPITAL. 34 34 0 18 0 0 0 0 285600 259700 2836 1778 0 0 288436 261478 0 0 0 0 156750 137175 0 0 0 83332 135959 240082 273134 48354 -11656 432114 420201 0 0 432114 420201 THE ORGANIZATION IS DEDICATED TO THE TASK OF PROMOTING HIGH QUALITY MEDICAL CARE FOR ALL PATIENTS ADMITTED TO OR TREATED IN THE HOSPITAL. 0 0 225518 ASSURE THAT ALL PATIENTS ADMITTED TO THE HOSPITAL RECEIVE HIGH QUALITY OF CARE. PROVIDE MEDIATION BETWEEN GOOD SAMARITAN HOSPITAL AND MEDICAL STAFF. PROVIDE REGULATIONS FOR SELF-GOVERNANCE OF MEDICAL STAFF. FOSTER ATMOSPHERE OF EDUCATION AND RESEARCH. MAINTAIN HIGH PROFESSIONAL AND ETHICAL STANDARDS. 225518 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 0 0 0 0 0 0 0 0 0 X 34 34 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JANE YIEH TREASURER 4085592388 2425 SAMARITAN DRIVE SAN JOSE CA 951243809 CECIL BRADLEY MD CHAIR 1.00 X 1000 0 0 BALDEV SINGH MD CHIEF OF STAFF 1.00 X X 30000 0 0 GOPI AYER MD CHIEF OF STAFF-ELECT 1.00 X 0 0 0 JANE YIEH MD SECRETARY-TREASURER 5.00 X X 6000 0 0 ANUP SINGH MD PAST CHIEF OF STAFF 20.00 X X 75000 0 0 CK PARK MD CHAIR/ADVISORY COUNCIL 1.00 X 0 0 0 MING-YUN TANG MD VICE CHAIR 1.00 X 0 0 0 GEORGE LEE MD CHAIR 1.00 X 0 0 0 MOHAMMED QAYYUM MD VICE CHAIR 1.00 X 0 0 0 KENNETH ONG MD CHAIR 1.00 X 2000 0 0 JUDONG PAN MD VICE CHAIR 1.00 X 0 0 0 DAVID FELDMAN CHAIR 1.00 X 2000 0 0 MY PHOUNG MITARAI MD VICE CHAIR 1.00 X 0 0 0 JOHN RASHKIS MD CHAIR 1.00 X 2000 0 0 SATYA CHELAMKURI MD VICE CHAIR 1.00 X 0 0 0 DIANA TSAI MD CHAIR 1.00 X 3000 0 0 ALEXANDER PHAM MD VICE CHAIR 1.00 X 3000 0 0 FAHD KHAN MD CHAIR 1.00 X 500 0 0 SONYA PATEL DO VICE CHAIR 1.00 X 675 0 0 NIDHI JACOB MD CHAIR 1.00 X 0 0 0 MARK FIERRO MD VICE CHAIR 1.00 X 0 0 0 KRIKOR BARSOUMIAN MD CHAIR 1.00 X 2000 0 0 HOWARD CHEN MD VICE CHAIR 1.00 X 0 0 0 SANDEEP GIDVANI MD CHAIR 1.00 X 4000 0 0 JOTHI MURALI MD VICE CHAIR 1.00 X 0 0 0 SALMA DABIRI MD CHAIR 1.00 X 2000 0 0 MONICA ENERIZ WIEMER MD CHAIR 1.00 X 3000 0 0 PUI LAI MD VICE CHAIR 1.00 X 0 0 0 KIRK CHURUKIAN MD CHAIR 1.00 X 0 0 0 MOHAMMADREZA ROHANINEJAD MD VICE CHAIR 1.00 X 0 0 0 MAHSA ESFAHANI MD MEMBER AT LARGE 1.00 X 1000 0 0 DANAGRA IKOSSI MD MEMBER AT LARGE 1.00 X 0 0 0 LINDA CHUNG MD ADVISORY COUNCIL 1.00 X 0 0 0 RAJEEV TANDON MD ADVISORY COUNCIL 1.00 X 0 0 0 137175 0 0 0 0 0 0 0 MEMBERSHIP DUES & ASSE 621110 184500 184500 MEMBERSHIP DUES & ASSE 621110 75200 75200 259700 1778 1778 38000 38000 0 0 261478 259700 0 1778 X 137175 123457 13718 27960 27960 1700 1700 1441 1441 50000 50000 PPEC EXPENSE 35775 35775 LEADERSHIP EDUCATION 14114 14114 OUTSIDE SERVICES 2784 2784 MEMBERSHIP 2000 2000 185 172 13 273134 225518 47616 0 322916 310996 109198 109205 432114 420201 0 0 X 0 0 175901 175901 256213 244300 432114 420201 432114 420201 -11656 -257 0 X 0 0 0 0 0 0 259700 FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - FORM 990 IS AVAILABLE TO THE GOVERNING BODY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEETING DISCUSSION. AN INDIVIDUAL WHO BELIEVES THAT HE MAY HAVE A REAL OR APPARENT CONFLICT OF INTEREST MUST ABSTAIN FROM PARTICIPATING IN DISCUSSIONS OR DELIBERATIONS, USING PERSONAL INFLUENCE TO AFFECT DELIBERATIONS, MAKING MOTIONS, VOTING, EXECUTING AGREEMENTS, OR OTHER SIMILAR ACTIONS IN RESPECT TO THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS AND APPROVES THE OFFICERS COMPENSATION BASED ON PERFORMANCE, LONGEVITY, IMPORTANCE OF THE PERSON OF THE ORGANIZATION AND THE MARKET IN THE GEOGRAPHIC AREA. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 AND GOVERNING DOCUMENTS ARE AVAILABLE AT NON-PROFIT WEB SITES AND UPON REQUEST FROM THE ORGANIZATION. FORM 990, PART IX, LINE 11G PHYSICIAN STIPENDS: PROGRAM SERVICE EXPENSES 50,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,000.