# JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Golden Shore Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538431242
- **Authorized official:** GLORIA CALDERON (VICE PRESIDENT, CLINIC OPERATIONS)
- **Authorized official phone:** (626) 346-2455

## Contact information

- **Practice address:** 11965 CACTUS RD, ADELANTO, CA 92301-4906
- **Practice address phone:** (760) 561-6081
- **Practice address fax:** (877) 778-9461
- **Mailing address:** 625 FAIR OAKS AVE STE 270, SOUTH PASADENA, CA 91030-5801
- **Mailing address phone:** (626) 346-2455
- **Mailing address fax:** (626) 639-3005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | CA | Yes |
| 208000000X | Pediatrics Physician | — | CA | — |

## Other

- **Enumeration date:** 01/27/2012
- **Last updated:** 02/07/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | APPROVED 1/31/12 | — | CA |
| 01 | — | DU4034-EFF.3/6/12 | RAILROAD MEDICARE | CA |