# MOLINA MEDICAL GROUP OF MICHIGAN, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avalon Health Center, Avalon Health Center-Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497279020
- **Authorized official:** J MARIO MOLINA MD (OWNER)
- **Authorized official phone:** (562) 499-6191

## Contact information

- **Practice address:** 4700 SCHAEFER RD, DEARBORN, MI 48126-3655
- **Practice address phone:** (313) 581-2600
- **Practice address fax:** (313) 581-0228
- **Mailing address:** 4700 SCHAEFER RD, DEARBORN, MI 48126-3655
- **Mailing address phone:** (313) 581-2600
- **Mailing address fax:** (313) 581-0228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2017
- **Last updated:** 07/21/2022